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General NPI Number Information
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NPI Number | 1851823330
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Entity Type | Organization
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Legal Business Name | WILLARD EYE CARE INC
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 320 W WALTON ST
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City | WILLARD
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State | OH
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Zip | 44890
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Country | US
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Telephone | 419-933-2741
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Fax | 419-933-7281
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Provider Business Mailing Address
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Address Line | PO BOX 270
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City | WILLARD
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State | OH
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Zip | 44890
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Country | US
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Telephone | 419-933-2741
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Fax | 419-933-7281
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Authorized Official
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Title or Position | OPTOMETRIST, PRESIDENT
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Name | DR. TIFFANY PROCACCINI
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Credential | OD
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Telephone | 567-207-5503
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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 | 5906
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License Number State | OH
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