Organization
WILLIAM KEGERIZE OD LLC
Active
Parent organization
WILLIAM KEGERIZE OD LLC
Other names
Genoa Family Eyecare
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAM KEGERIZE OD LLC
Authorized official
DR. WILLIAM R KEGERIZE O.D. (OWNER)
(419) 855-3640
Entity
Organization
Contact information
Practice address
603 MAIN ST, GENOA, OH 43430-1635
(419) 855-3640
(419) 855-4743
Mailing address
603 MAIN ST, GENOA, OH 43430-1635
(419) 855-3640
(419) 855-4743
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
OH5558
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3037403
—
OH
Enumeration date
01/25/2010
Last updated
09/27/2016
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