Healthcare Provider Details

I. General information

NPI: 1164651980
Provider Name (Legal Business Name): BILL B HANCE LDO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8211 CORNELL RD SUITE 510
CINCINNATI OH
45249-2273
US

IV. Provider business mailing address

8211 CORNELL RD SUITE 510
CINCINNATI OH
45249-2273
US

V. Phone/Fax

Practice location:
  • Phone: 513-489-4000
  • Fax: 513-530-0473
Mailing address:
  • Phone: 513-489-4000
  • Fax: 513-530-0473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberS5052
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: