Healthcare Provider Details

I. General information

NPI: 1700988987
Provider Name (Legal Business Name): OHLEN P. CARTMELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 12/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 2ND ST
MARIETTA OH
45750-2919
US

IV. Provider business mailing address

316 2ND ST
MARIETTA OH
45750-2919
US

V. Phone/Fax

Practice location:
  • Phone: 740-374-3937
  • Fax: 740-376-9437
Mailing address:
  • Phone: 740-374-3937
  • Fax: 740-376-9437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4269-T046
License Number StateOH

VIII. Authorized Official

Name: DR. OHLEN PIERCE CARTMELL
Title or Position: OWNER
Credential: O.D.
Phone: 740-374-3937