Healthcare Provider Details

I. General information

NPI: 1235397555
Provider Name (Legal Business Name): CHERI J. GLAUS, O.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 07/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3725 CLEVELAND MASSILLON RD SUITE 6
NORTON OH
44203-5614
US

IV. Provider business mailing address

3725 CLEVELAND MASSILLON RD SUITE 6
NORTON OH
44203-5614
US

V. Phone/Fax

Practice location:
  • Phone: 330-825-6004
  • Fax: 330-825-3601
Mailing address:
  • Phone: 330-825-6004
  • Fax: 330-825-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3581 / T462
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number3581 /T462
License Number StateOH

VIII. Authorized Official

Name: DR. CHERI J GLAUS
Title or Position: PRESIDENT
Credential: O.D.
Phone: 330-825-6004