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General NPI Number Information
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NPI Number | 1104155035
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Entity Type | Organization
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Legal Business Name | MELISSA BOWMAN OD INC
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Dates
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Enumeration Date | 12/24/2009
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Last Update Date | 02/14/2013
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Provider Practice Location Address
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Address Line | 11919 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45249-2019
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Country | US
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Telephone | 513-583-8970
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Fax | 513-583-9072
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Provider Business Mailing Address
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Address Line | 11919 MONTGOMERY RD
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City | CINCINNATI
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State | OH
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Zip | 45249-2019
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Country | US
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Telephone | 513-583-8970
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Fax | 513-583-9072
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MELISSA BOWMAN
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Credential | OD
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Telephone | 513-583-8970
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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 | 5375
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License Number State | OH
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