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General NPI Number Information
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NPI Number | 1376612135
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Entity Type | Organization
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Legal Business Name | JOHN M. PRICE OD, INC.
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 113 NORTH FIRST ST.
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City | OAKWOOD
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State | OH
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Zip | 45873
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Country | US
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Telephone | 419-594-3340
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Fax | 419-594-3300
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Provider Business Mailing Address
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Address Line | 113 NORTH FIRST ST. P.O. BOX 168
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City | OAKWOOD
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State | OH
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Zip | 45873
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Country | US
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Telephone | 419-594-3340
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Fax | 419-594-3300
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CLARINDA Y WINE
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Credential | L.D.O.
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Telephone | 419-594-3340
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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 | 5062
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License Number State | OH
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