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General NPI Number Information
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NPI Number | 1194243766
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Entity Type | Organization
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Legal Business Name | HEATHER L. PAULUS, O.D. LLC
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 10/02/2017
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Provider Practice Location Address
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Address Line | 1657 HOLLAND RD STE D
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City | MAUMEE
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State | OH
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Zip | 43537-1661
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Country | US
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Telephone | 419-891-1023
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Fax | 419-891-1138
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Provider Business Mailing Address
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Address Line | 1657 HOLLAND RD STE D
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City | MAUMEE
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State | OH
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Zip | 43537-1661
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Country | US
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Telephone | 419-891-1023
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Fax | 419-891-1138
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUE I. TOCZYNSKI
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Credential |
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Telephone | 419-891-1023
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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 | 6399
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License Number State | OH
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