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Organization

VISION SOURCE MARYSVILLE

Active
Parent organization
COURTNEY L POLING OD
Other names
Courtney Lynn Poling OD
Organization subpart
Yes

Provider details

NPI number
Legal business name
COURTNEY L POLING OD
Authorized official
MRS. MALLORIE GOODRIDGE (OFFICE MANAGER)
(937) 644-8637
Entity
Organization

Contact information

Practice address
303 W 5TH ST, MARYSVILLE, OH 43040-1113
(937) 644-2075
Mailing address
303 W 5TH ST, MARYSVILLE, OH 43040-1113

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Enumeration date
08/13/2020
Last updated
05/10/2021
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