Healthcare Provider Details
I. General information
NPI: 1801846084
Provider Name (Legal Business Name): LOUIS RODIER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 05/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
811 E MAIN ST
TORRINGTON CT
06790-3930
US
IV. Provider business mailing address
87 GRANDVIEW AVE
WATERBURY CT
06708-2514
US
V. Phone/Fax
- Phone: 860-496-8668
- Fax: 860-496-7052
- Phone: 203-574-2020
- Fax: 203-596-2230
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 002065 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: