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Organization

DR WESTON R MANGOLD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WESTON RAY MANGOLD O.D. (OPTOMETRIST)
(937) 321-1033
Entity
Organization

Contact information

Practice address
1274 E 2ND ST, FRANKLIN, OH 45005-1994
(937) 704-0809
Mailing address
7152 QUARTERHORSE DR, SPRINGBORO, OH 45066-7784
(937) 321-1033

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4122
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2841590
OH
Enumeration date
10/26/2009
Last updated
10/26/2009
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