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General NPI Number Information
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NPI Number | 1447472329
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Entity Type | Organization
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Legal Business Name | DR NATHANIEL J. LEGGETT, INC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 05/11/2023
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Provider Practice Location Address
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Address Line | 4822 CLEVELAND AVE S
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City | CANTON
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State | OH
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Zip | 44707-1034
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Country | US
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Telephone | 330-484-2569
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Fax | 330-236-8188
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Provider Business Mailing Address
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Address Line | 4822 CLEVELAND AVE S
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City | CANTON
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State | OH
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Zip | 44707-1034
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Country | US
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Telephone | 330-484-2569
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Fax | 330-236-8188
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Authorized Official
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Title or Position | PRESIDENT/TREASURER
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Name | DR. NATHANIEL JAMES LEGGETT
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Credential | OD
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Telephone | 330-484-2569
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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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