Individual
MICHELLE RENEA VEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6001 MAHONING AVE, AUSTINTOWN, OH 44515-2298
(330) 270-0013
(330) 270-0015
Mailing address
6001 MAHONING AVE, AUSTINTOWN, OH 44515-2298
(330) 270-0013
(330) 270-0015
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4164
—
OH
05
—
OPTICIAN
—
OH
Enumeration date
03/06/2023
Last updated
03/06/2023
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