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General NPI Number Information
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NPI Number | 1447374822
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Entity Type | Organization
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Legal Business Name | DREFFER,HICKS&DEMOS, O.D., INC.
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 02/02/2010
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Provider Practice Location Address
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Address Line | 310 WILLIAMS ST
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City | HURON
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State | OH
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Zip | 44839-1648
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Country | US
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Telephone | 419-433-2630
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Fax | 419-433-2285
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Provider Business Mailing Address
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Address Line | 310 WILLIAMS ST
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City | HURON
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State | OH
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Zip | 44839-1648
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Country | US
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Telephone | 419-433-2630
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Fax | 419-433-2285
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Authorized Official
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Title or Position | FRONT DESK ADMINISTRATOR
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Name | MRS. CARON S LINDSLEY
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Credential |
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Telephone | 419-433-2630
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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 | 2728
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License Number State | OH
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