Healthcare Provider Details

I. General information

NPI: 1538399977
Provider Name (Legal Business Name): GROVE CITY VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2009
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3959 HOOVER RD
GROVE CITY OH
43123-2839
US

IV. Provider business mailing address

3959 HOOVER RD
GROVE CITY OH
43123-2839
US

V. Phone/Fax

Practice location:
  • Phone: 614-875-8373
  • Fax: 614-875-0974
Mailing address:
  • Phone: 614-875-8373
  • Fax: 614-875-0974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2928/T981
License Number StateOH

VIII. Authorized Official

Name: DR. JOHN W ZAHARA
Title or Position: OPTOMETRIST
Credential:
Phone: 614-875-8373