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General NPI Number Information
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NPI Number | 1689741969
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Entity Type | Organization
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Legal Business Name | TRISTATE CENTERS FOR SIGHT, INC.
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 8040 HOSBROOK RD SUITE 100
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City | CINCINNATI
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State | OH
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Zip | 45236-2901
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Country | US
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Telephone | 513-891-0473
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Fax | 513-891-0543
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Provider Business Mailing Address
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Address Line | PO BOX 631662
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City | CINCINNATI
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State | OH
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Zip | 45263-1662
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Country | US
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Telephone | 859-581-7120
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Fax | 859-581-7207
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DANIEL A NORDLOH
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Credential |
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Telephone | 859-581-7120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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