Healthcare Provider Details

I. General information

NPI: 1942095831
Provider Name (Legal Business Name): JULIE DIANE ANDERSON OPTICIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4627 AICHOLTZ RD
CINCINNATI OH
45244-1447
US

IV. Provider business mailing address

424 WARDS CORNER RD STE 200
LOVELAND OH
45140-6966
US

V. Phone/Fax

Practice location:
  • Phone: 513-732-5082
  • Fax: 513-214-2408
Mailing address:
  • Phone: 513-576-7700
  • Fax: 513-576-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberOP.017234-S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: