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General NPI Number Information
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NPI Number | 1861687469
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Entity Type | Organization
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Legal Business Name | JOHN A. WIENER, OD & ASSOCIATES, INC.
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Dates
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Enumeration Date | 09/07/2007
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 9998 KINGS AUTO MALL RD
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City | CINCINNATI
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State | OH
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Zip | 45249-8234
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Country | US
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Telephone | 513-683-9960
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Fax | 513-697-6215
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Provider Business Mailing Address
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Address Line | 9998 KINGS AUTO MALL RD
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City | CINCINNATI
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State | OH
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Zip | 45249-8234
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Country | US
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Telephone | 513-683-9960
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Fax | 513-697-6215
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN ANTHONY WIENER
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Credential | O.D.
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Telephone | 513-683-9960
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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 | 4061 T245
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License Number State | OH
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