Healthcare Provider Details

I. General information

NPI: 1144462862
Provider Name (Legal Business Name): WOODY WILLIAMS VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2009
Last Update Date: 03/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 TOWNE BLVD SUITE B
FRANKLIN OH
45005-5543
US

IV. Provider business mailing address

3600 TOWNE BLVD SUITE B
FRANKLIN OH
45005-5543
US

V. Phone/Fax

Practice location:
  • Phone: 513-424-5217
  • Fax: 513-424-0205
Mailing address:
  • Phone: 513-424-5217
  • Fax: 513-424-0205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number2467SC
License Number StateOH

VIII. Authorized Official

Name: MR. WOODY WILLIAMS
Title or Position: OWNER
Credential: LICENSED OPTICIAN
Phone: 513-424-5217