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General NPI Number Information
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NPI Number | 1013381342
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Entity Type | Organization
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Legal Business Name | SAWYER VISION HOLDINGS LLC
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Dates
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Enumeration Date | 11/24/2015
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Last Update Date | 12/21/2016
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Provider Practice Location Address
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Address Line | 1131 LAURELWOOD LN
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City | INDEPENDENCE
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State | KY
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Zip | 41051-9064
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Country | US
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Telephone | 513-633-0060
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Fax |
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Provider Business Mailing Address
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Address Line | 1131 LAURELWOOD LN
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City | INDEPENDENCE
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State | KY
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Zip | 41051-9064
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Country | US
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Telephone | 513-633-0060
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Fax |
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Authorized Official
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Title or Position | MEMBER/OPTOMETRIST
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Name | DR. KENNETH NORMAN SAWYER III
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Credential | OD
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Telephone | 513-633-0060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1632DT
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License Number State | KY
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