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General NPI Number Information
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NPI Number | 1588848667
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Entity Type | Organization
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Legal Business Name | MMEC LLC
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 535 ADRIAN DR
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City | DELAWARE
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State | OH
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Zip | 43015-3097
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Country | US
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Telephone | 614-325-1448
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Fax | 614-438-0103
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Provider Business Mailing Address
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Address Line | 535 ADRIAN DR
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City | DELAWARE
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State | OH
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Zip | 43015-3097
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Country | US
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Telephone | 614-325-1448
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Fax | 614-438-0103
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Authorized Official
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Title or Position | OPTOMETRIST - SOLE OWNER
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Name | DR. MICHAEL S MAYERS
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Credential | O.D,.
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Telephone | 614-325-1448
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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 | 5405 T2316
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License Number State | OH
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