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General NPI Number Information
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NPI Number | 1144844291
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Entity Type | Organization
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Legal Business Name | EYESTYLE OF AMERICA LTD
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Dates
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Enumeration Date | 06/04/2020
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 10700 MONTGOMERY RD STE 221
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City | MONTGOMERY
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State | OH
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Zip | 45242-3296
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Country | US
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Telephone | 513-247-0851
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Fax |
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Provider Business Mailing Address
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Address Line | 10700 MONTGOMERY RD STE 221
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City | MONTGOMERY
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State | OH
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Zip | 45242-3296
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Country | US
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Telephone | 513-247-0851
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Fax |
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Authorized Official
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Title or Position | VP
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Name | ED AZER
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Credential |
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Telephone | 513-247-0851
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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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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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