Healthcare Provider Details

I. General information

NPI: 1467566307
Provider Name (Legal Business Name): AMY G LIU O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 03/25/2024
Certification Date: 03/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 MORSE RD
COLUMBUS OH
43219-3016
US

IV. Provider business mailing address

367 E JENKINS AVE
COLUMBUS OH
43207-1235
US

V. Phone/Fax

Practice location:
  • Phone: 614-476-2086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5633
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: