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General NPI Number Information
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NPI Number | 1851535652
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Entity Type | Organization
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Legal Business Name | AUGLAIZE FAMILY EYE CARE INC
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 1201 DEFIANCE ST SUITE A
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City | WAPAKONETA
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State | OH
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Zip | 45895-1086
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Country | US
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Telephone | 419-738-2715
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Fax | 419-738-2815
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Provider Business Mailing Address
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Address Line | 1201 DEFIANCE ST SUITE A
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City | WAPAKONETA
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State | OH
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Zip | 45895-1086
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Country | US
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Telephone | 419-738-2715
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Fax | 419-738-2815
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN M PRICE
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Credential | OD
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Telephone | 419-738-2715
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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 | 5062 T1939
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License Number State | OH
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