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General NPI Number Information
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NPI Number | 1851758890
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Entity Type | Organization
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Legal Business Name | DR KOHLER AND ASSOCIATES INC
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 2578 ENTERPRISE RD UNIT 167
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City | ORANGE CITY
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State | FL
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Zip | 32763-7904
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Country | US
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Telephone | 386-216-4738
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Fax | 386-218-4085
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Provider Business Mailing Address
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Address Line | 2578 ENTERPRISE RD UNIT 167
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City | ORANGE CITY
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State | FL
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Zip | 32763-7904
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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 | OWNER
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Name | TONYA M KOHLER
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Credential | O.D.
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Telephone | 386-216-4738
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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 | OPC4598
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License Number State | FL
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