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General NPI Number Information
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NPI Number | 1306087184
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Entity Type | Organization
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Legal Business Name | THOMAS J CHAMBERS OD INC
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Dates
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Enumeration Date | 03/09/2009
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Last Update Date | 03/09/2009
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Provider Practice Location Address
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Address Line | 2845 S STATE ROUTE 100
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City | TIFFIN
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State | OH
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Zip | 44883-8974
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Country | US
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Telephone | 419-447-2143
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Fax | 419-447-1595
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Provider Business Mailing Address
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Address Line | 2845 S STATE ROUTE 100
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City | TIFFIN
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State | OH
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Zip | 44883-8974
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Country | US
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Telephone | 419-447-2143
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Fax | 419-447-1595
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS J CHAMBERS
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Credential | O.D.
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Telephone | 419-447-2143
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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 | 3764
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License Number State | OH
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