Healthcare Provider Details

I. General information

NPI: 1568467074
Provider Name (Legal Business Name): HETZLER OCULAR PROSTHETIC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 TRI COUNTY PKWY STE 201
CINCINNATI OH
45246-3235
US

IV. Provider business mailing address

130 TRI COUNTY PKWY STE 201
CINCINNATI OH
45246-3235
US

V. Phone/Fax

Practice location:
  • Phone: 513-771-6029
  • Fax:
Mailing address:
  • Phone: 513-771-6029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1700X
TaxonomyOcularist
License Number0.11
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberO.11
License Number StateOH

VIII. Authorized Official

Name: MRS. KATHY J HETZLER
Title or Position: PRESIDENT
Credential: B.C.O.
Phone: 317-598-6298