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General NPI Number Information
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NPI Number | 1225151277
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Entity Type | Organization
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Legal Business Name | DANIEL R FRESON OD INC
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 1730 W 25TH ST
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City | CLEVELAND
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State | OH
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Zip | 44113-3108
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Country | US
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Telephone | 216-771-8311
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Fax | 216-771-7450
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Provider Business Mailing Address
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Address Line | 2012 W 25TH ST ROOM 1
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City | CLEVELAND
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State | OH
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Zip | 44113-4135
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Country | US
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Telephone | 216-771-8311
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Fax | 216-771-7450
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL R. FRESON
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Credential | OD
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Telephone | 216-771-8311
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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 | OH3347T441
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License Number State | OH
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