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General NPI Number Information
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NPI Number | 1689041477
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Entity Type | Organization
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Legal Business Name | POSITIONAL ADVANTAGE CORPORATION
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 12/08/2015
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Provider Practice Location Address
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Address Line | 29 GRANDVIEW AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1039
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Country | US
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Telephone | 419-228-3800
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Fax | 419-222-1596
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Provider Business Mailing Address
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Address Line | 121 W CENTRAL AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1905
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Country | US
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Telephone | 419-569-4790
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN KOCHER
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Credential | OD
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Telephone | 419-228-3800
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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 | 6134
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License Number State | OH
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