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General NPI Number Information
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NPI Number | 1235327461
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER J MEYER
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Dates
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Enumeration Date | 10/12/2007
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 10730 MAIN ST.,
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City | MANTUA
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State | OH
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Zip | 44255-0520
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Country | US
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Telephone | 330-274-0502
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Fax | 330-274-8184
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Provider Business Mailing Address
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Address Line | PO BOX 520
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City | MANTUA
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State | OH
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Zip | 44255-0520
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Country | US
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Telephone | 330-274-0502
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Fax | 330-274-8184
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER J MEYER
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Credential | O.D.
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Telephone | 330-274-0502
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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 | 4034T171
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License Number State | OH
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