Individual
DR. LYLE EDWARD NOWICKI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
111 CLOUGH ST, BOWLING GREEN, OH 43402-2901
(419) 352-3223
(419) 352-5485
Mailing address
111 CLOUGH ST, BOWLING GREEN, OH 43402-2901
(419) 352-3223
(419) 352-5485
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2867/T581
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0144409
—
OH
01
—
03385
PARAMOUNT HMO PROVIDER #
OH
Enumeration date
11/30/2005
Last updated
07/09/2007
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