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General NPI Number Information
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NPI Number | 1164610911
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Entity Type | Organization
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Legal Business Name | WING EYECARE, INC
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 5303 GLENWAY AVE
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City | CINCINNATI
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State | OH
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Zip | 45238-3706
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Country | US
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Telephone | 513-921-8040
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Fax |
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Provider Business Mailing Address
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Address Line | 5303 GLENWAY AVE
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City | CINCINNATI
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State | OH
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Zip | 45238-3706
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Country | US
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Telephone | 513-921-8040
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | THOMAS F NAGY
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Credential | O.D.
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Telephone | 513-921-8433
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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 | 4416
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License Number State | OH
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