Organization
COSHOCTON VISION CENTER, LLC
Active
Other names
Tri-Valley Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES WILLIAM FORNARA OD (MEMBER / OWNER)
(740) 622-1484
Entity
Organization
Contact information
Practice address
95 W DAVE LONGABERGER AVE, DRESDEN, OH 43821-9687
(740) 754-3800
(740) 754-2050
Mailing address
95 W DAVE LONGABERGER AVE, DRESDEN, OH 43821-9687
(740) 754-3800
(740) 754-2050
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5622
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0099076
—
OH
05
—
2873832
—
OH
Enumeration date
09/20/2010
Last updated
10/16/2019
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