Healthcare Provider Details

I. General information

NPI: 1477735538
Provider Name (Legal Business Name): EYES ON MAIN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 01/24/2020
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 S MAIN ST
FINDLAY OH
45840-3353
US

IV. Provider business mailing address

334 S MAIN ST
FINDLAY OH
45840-3353
US

V. Phone/Fax

Practice location:
  • Phone: 419-422-2015
  • Fax: 419-427-9477
Mailing address:
  • Phone: 419-422-2015
  • Fax: 419-427-9477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3756T705
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number3756T705
License Number StateOH

VIII. Authorized Official

Name: DR. DUANE LESLIE WIRES
Title or Position: PRESIDENT
Credential: O.D.
Phone: 419-422-2015