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General NPI Number Information
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NPI Number | 1427374826
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Entity Type | Organization
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Legal Business Name | CLEARVIEW EYE CARE
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Dates
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Enumeration Date | 04/12/2010
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 6180 GLENWAY AVE UNIT H
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City | CINCINNATI
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State | OH
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Zip | 45211-6320
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Country | US
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Telephone | 513-662-0157
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Fax | 513-389-3396
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Provider Business Mailing Address
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Address Line | PO BOX 688
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City | WEST CHESTER
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State | OH
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Zip | 45071-0688
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KWEKU MICAH
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Credential | O.D.
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Telephone | 513-488-9157
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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 | 5732
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License Number State | OH
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