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Organization

PLAZA OPTOMETRISTS INC.

Active
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Organization

PLAZA OPTOMETRISTS INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARTIN G. ELLIS O.D. (OWNER)
(330) 638-4097
Entity
Organization

Contact information

Practice address
3018 STATE ROUTE 5, SUITE C, CORTLAND, OH 44410-9178
(330) 638-4097
(330) 637-0140
Mailing address
20 W FEDERAL ST, SUITE T 4, YOUNGSTOWN, OH 44503-1420
(330) 638-4097
(330) 637-0140

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3343 T420
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NUMBERS PENDING
NUMBERS PENDING
OH
Enumeration date
10/14/2008
Last updated
10/21/2008
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