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General NPI Number Information
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NPI Number | 1295860559
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Entity Type | Organization
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Legal Business Name | GUNNING AMES PTRS
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 218 E NORTH ST
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City | WAVERLY
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State | OH
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Zip | 45690-1148
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Country | US
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Telephone | 740-947-2945
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Fax | 740-947-1458
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Provider Business Mailing Address
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Address Line | 218 E NORTH ST
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City | WAVERLY
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State | OH
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Zip | 45690-1148
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Country | US
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Telephone | 740-947-2945
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Fax | 740-947-1458
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | JOHN N GUNNING II
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Credential | O.D.
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Telephone | 740-947-2945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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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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