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General NPI Number Information
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NPI Number | 1356488035
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Entity Type | Organization
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Legal Business Name | CHILDREN'S EYE CARE CENTER OF NORTHWEST OHIO, INC.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 842 W SOUTH BOUNDARY ST
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City | PERRYSBURG
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State | OH
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Zip | 43551-5265
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Country | US
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Telephone | 419-872-9777
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Fax | 419-872-9781
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Provider Business Mailing Address
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Address Line | 842 W SOUTH BOUNDARY ST
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City | PERRYSBURG
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State | OH
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Zip | 43551-5265
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Country | US
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Telephone | 419-872-9777
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Fax | 419-872-9781
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICIA A WELTER
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Credential | MD
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Telephone | 419-872-9777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35053982W
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License Number State | OH
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