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General NPI Number Information
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NPI Number | 1760858005
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Entity Type | Individual
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Provider Name | MELISSA MCCAULEY
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Gender | Female
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Dates
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Enumeration Date | 08/20/2015
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 5584 DRESSLER RD NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-7757
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Country | US
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Telephone | 330-305-9305
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2414
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City | NORTH CANTON
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State | OH
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Zip | 44720-0414
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Country | US
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Telephone |
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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 | 4858
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License Number State | OH
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