Healthcare Provider Details

I. General information

NPI: 1215342928
Provider Name (Legal Business Name): WEST POINT OPTICAL BRIDGEWATER FALLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 06/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3373 PRINCETON RD #121
HAMILTON OH
45011-5416
US

IV. Provider business mailing address

3373 PRINCETON RD #121
HAMILTON OH
45011-5416
US

V. Phone/Fax

Practice location:
  • Phone: 513-893-1461
  • Fax:
Mailing address:
  • Phone: 513-893-1461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: CASEY STRONG
Title or Position: STORE GENERAL MANAGER
Credential:
Phone: 513-893-1461