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General NPI Number Information
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NPI Number | 1114426707
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Entity Type | Organization
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Legal Business Name | JOSEPH M PEDERZOLLI LLC
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Dates
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Enumeration Date | 02/08/2018
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Last Update Date | 02/08/2018
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Provider Practice Location Address
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Address Line | 32 E BROADWAY ST
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City | ALLIANCE
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State | OH
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Zip | 44601-2647
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Country | US
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Telephone | 330-913-7333
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Fax | 330-913-7334
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Provider Business Mailing Address
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Address Line | PO BOX 2938
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City | ALLIANCE
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State | OH
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Zip | 44601-0938
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Country | US
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Telephone | 330-206-9401
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Fax | 330-913-7333
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MICHELE PEDERZOLLI
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Credential |
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Telephone | 330-913-7333
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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 | 3433T596
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License Number State | OH
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