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General NPI Number Information
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NPI Number | 1063683647
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Entity Type | Organization
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Legal Business Name | DR. JOHN J DEVITO INC.
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 08/06/2012
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Provider Practice Location Address
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Address Line | 3703 CLEVELAND AVE NW
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City | CANTON
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State | OH
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Zip | 44709-2315
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Country | US
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Telephone | 330-493-9803
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Fax | 330-493-9804
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Provider Business Mailing Address
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Address Line | 3703 CLEVELAND AVE NW
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City | CANTON
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State | OH
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Zip | 44709-2315
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Country | US
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Telephone | 330-493-9803
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Fax | 330-493-9804
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN JOSEPH DEVITO
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Credential | OD
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Telephone | 330-493-9803
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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 | 4094/T86
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License Number State | OH
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