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General NPI Number Information
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NPI Number | 1831894476
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Entity Type | Organization
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Legal Business Name | RICHARDSON OPTOMETRIC SERVICES LLC
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 500 SOUTHPARK CTR # CL316
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City | STRONGSVILLE
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State | OH
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Zip | 44136-9320
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Country | US
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Telephone | 440-238-0716
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Fax | 440-238-3369
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Provider Business Mailing Address
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Address Line | 10499 WHITE ASH TRL
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City | TWINSBURG
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State | OH
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Zip | 44087-2659
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Country | US
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Telephone | 330-414-1548
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. EDMUND NATHANIEL TURNER
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Credential | OD
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Telephone | 330-414-1548
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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 |
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License Number State |
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