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General NPI Number Information
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NPI Number | 1376836379
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Entity Type | Organization
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Legal Business Name | DR HENRY G. COVETTA, CO
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 1484 STATE ROUTE 46 N
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City | JEFFERSON
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State | OH
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Zip | 44047-8145
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Country | US
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Telephone | 440-624-4222
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Fax | 440-624-4232
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Provider Business Mailing Address
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Address Line | 1484 STATE ROUTE 46 NORTH
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City | JEFFERSON
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State | OH
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Zip | 44047
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Country | US
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Telephone | 440-624-4222
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Fax | 440-624-4232
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. HENRY G COVETTA
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Credential | OD
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Telephone | 440-624-4222
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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 |
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License Number State |
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