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General NPI Number Information
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NPI Number | 1477734838
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Entity Type | Organization
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Legal Business Name | CHESTER EYE CENTER INC
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 261 N WOODBRIDGE AVE
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-2246
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Country | US
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Telephone | 740-773-2020
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Fax | 740-773-8957
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Provider Business Mailing Address
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Address Line | 261 N WOODBRIDGE AVE PO BOX 915
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City | CHILLICOTHEE
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State | OH
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Zip | 45601-2246
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Country | US
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Telephone | 740-773-2020
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Fax | 740-773-8957
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. MICHAEL E CHESTER
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Credential | O.D.
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Telephone | 740-773-2020
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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 | 3403 T383
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License Number State | OH
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