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General NPI Number Information
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NPI Number | 1275935439
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Entity Type | Individual
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Provider Name | DANIEL MARSAC O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 4100 W 3RD ST 112E OPTOMETRY
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City | DAYTON
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State | OH
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Zip | 45428-9000
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Country | US
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Telephone | 248-701-5878
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Fax |
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Provider Business Mailing Address
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Address Line | 425 DAYTON TOWERS DR APT 6J
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City | DAYTON
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State | OH
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Zip | 45410-1125
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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 |
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Name |
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Credential |
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Telephone |
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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 | 4901004870
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 4901004870
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 4901004870
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number | 4901004870
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License Number State | MI
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