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General NPI Number Information
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NPI Number | 1366622060
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Entity Type | Organization
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Legal Business Name | CARDINAL FAMILY EYE CARE, LLC
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Dates
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Enumeration Date | 11/09/2007
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Last Update Date | 02/20/2013
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Provider Practice Location Address
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Address Line | 885 HIGH ST STE 102
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City | WORTHINGTON
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State | OH
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Zip | 43085-4158
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Country | US
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Telephone | 614-888-5058
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Fax | 614-888-0679
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Provider Business Mailing Address
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Address Line | 885 HIGH ST STE 102
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City | WORTHINGTON
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State | OH
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Zip | 43085-4158
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Country | US
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Telephone | 614-888-5058
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Fax | 614-888-0679
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. SUSAN L GAYER
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Credential | O.D.
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Telephone | 614-888-5058
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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 | 5257
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License Number State | OH
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