Organization
LEWISBURG OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBIN SHIVERDECKER LDO (LICENSED OPTICIAN/OWNER)
(937) 962-4444
Entity
Organization
Contact information
Practice address
210 N COMMERCE ST, LEWISBURG, OH 45338-9343
(937) 962-4444
(937) 962-4443
Mailing address
210 N COMMERCE ST, PO BOX 658, LEWISBURG, OH 45338-9343
(937) 962-4444
(937) 962-4443
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
5728S
OH
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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