Individual
ROBERT O BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
800 N CLINTON ST, SUITE D, DEFIANCE, OH 43512-4610
(419) 782-1901
(419) 782-2200
Mailing address
22524 RIVER CHASE LN, DEFIANCE, OH 43512-6869
(419) 784-5329
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2752
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0342516
—
OH
Enumeration date
01/29/2007
Last updated
07/08/2007
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