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General NPI Number Information
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NPI Number | 1619756665
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Entity Type | Individual
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Provider Name | HANNAH MASSA OD
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Gender | Female
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Dates
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Enumeration Date | 09/27/2023
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 1449 BOARDMAN CANFIELD RD STE 230
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City | BOARDMAN
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State | OH
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Zip | 44512-8053
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Country | US
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Telephone | 330-758-6671
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Fax |
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Provider Business Mailing Address
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Address Line | 4325 MILLER RD
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City | FLINT
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State | MI
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Zip | 48507-1216
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Country | US
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Telephone | 810-394-6926
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPT.007221
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License Number State | OH
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