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General NPI Number Information
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NPI Number | 1811785850
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Entity Type | Individual
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Provider Name | BETH A TANKERSLEY LDO
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Gender | Female
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Dates
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Enumeration Date | 04/29/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 3710 BELMONT AVE
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City | YOUNGSTOWN
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State | OH
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Zip | 44505-1406
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Country | US
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Telephone | 330-759-8245
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Fax | 330-759-8245
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Provider Business Mailing Address
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Address Line | 482 GARVER DR
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City | BOARDMAN
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State | OH
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Zip | 44512-6512
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Country | US
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Telephone | 812-707-1106
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Fax | 812-707-1106
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | OP.005664-S
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License Number State | OH
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