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Individual

RICHARD THOMAS TABELING JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
7625 DOERING DR, FLORENCE, KY 41042
(859) 282-0881
Mailing address
1253 VIOLA LN, ERLANGER, KY 41018
(859) 342-5357

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1246DT
KY
152W00000X
Optometrist
4626
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2642591
OH
Enumeration date
07/03/2006
Last updated
07/08/2007
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