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General NPI Number Information
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NPI Number | 1124651385
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Entity Type | Organization
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Legal Business Name | RATH OPTOMETRY LLC
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 1174 ALLIANCE RD NW
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City | MINERVA
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State | OH
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Zip | 44657-8736
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Country | US
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Telephone | 330-868-0076
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Fax |
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Provider Business Mailing Address
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Address Line | 1174 ALLIANCE RD NW
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City | MINERVA
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State | OH
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Zip | 44657-8736
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Country | US
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Telephone | 330-868-0076
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | TED RATH
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Credential |
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Telephone | 330-494-5020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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