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General NPI Number Information
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NPI Number | 1043330871
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Entity Type | Organization
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Legal Business Name | DREFFER, HICKS, & DEMOS O.D. INC.
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 1074 WEST MCPHERSON HIGHWAY
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City | CLYDE
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State | OH
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Zip | 43410
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Country | US
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Telephone | 419-547-9126
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Fax | 419-547-0387
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Provider Business Mailing Address
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Address Line | 1074 WEST MCPHERSON HIGHWAY
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City | CLYDE
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State | OH
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Zip | 43410
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Country | US
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Telephone | 419-547-9126
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Fax | 419-547-0387
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Authorized Official
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Title or Position | OPTOMOTRIST
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Name | DR. HEATHER M DEMOS
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Credential | O.D.
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Telephone | 419-547-9126
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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 | 5022
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License Number State | OH
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