Healthcare Provider Details
I. General information
NPI: 1194913632
Provider Name (Legal Business Name): THOMA & SUTTON EYECARE PROFESSIONALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/10/2007
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5 SEVERANCE CIR SUITE 110
CLEVELAND HEIGHTS OH
44118-1566
US
IV. Provider business mailing address
2130 OSTERFELD ST
CINCINNATI OH
45214-1568
US
V. Phone/Fax
- Phone: 216-291-3020
- Fax: 216-291-0952
- Phone: 513-921-5590
- Fax: 513-921-2680
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LANCE
P.
SNARR
Title or Position: CEO
Credential:
Phone: 513-921-5590