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General NPI Number Information
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NPI Number | 1205451010
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Entity Type | Organization
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Legal Business Name | WC EYECARE LLC
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 05/22/2024
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Provider Practice Location Address
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Address Line | 512 CANTON RD
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City | AKRON
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State | OH
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Zip | 44312-2530
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Country | US
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Telephone | 330-784-1155
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Fax |
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Provider Business Mailing Address
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Address Line | 4570 BLACKBERRY CIR
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City | RAVENNA
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State | OH
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Zip | 44266-7841
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. WALTER COZZI
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Credential | OD
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Telephone | 330-289-9408
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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 |
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License Number State |
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