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General NPI Number Information
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NPI Number | 1477734291
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Entity Type | Organization
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Legal Business Name | JOHN A. KRUSZEWSKI O.D., INC
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 3723 KING RD SUITE 100
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City | TOLEDO
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State | OH
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Zip | 43617-1417
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Country | US
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Telephone | 419-843-2020
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Fax | 419-843-8733
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Provider Business Mailing Address
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Address Line | 3723 KING RD SUITE 100
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City | TOLEDO
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State | OH
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Zip | 43617-1417
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Country | US
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Telephone | 419-843-2020
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Fax | 419-843-8733
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Authorized Official
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Title or Position | PRESDIENT
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Name | JOHN A. KRUSZEWSKI
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Credential | O.D.
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Telephone | 419-843-2020
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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 | 3869T
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License Number State | OH
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