Individual
KEITH A BEDNARCZUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD INC
Contact information
Practice address
777 COLUMBUS AVE, LEBANON, OH 45036-1684
(513) 932-3343
(513) 932-0078
Mailing address
777 COLUMBUS AVE, LEBANON, OH 45036-1684
(513) 932-3343
(513) 932-0078
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3215 T351
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0323019
—
OH
Enumeration date
11/04/2005
Last updated
08/04/2010
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