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General NPI Number Information
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NPI Number | 1881912277
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Entity Type | Organization
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Legal Business Name | ALLEN HEALTH ASSOCIATES
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Dates
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Enumeration Date | 05/10/2010
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Last Update Date | 08/18/2010
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Provider Practice Location Address
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Address Line | 3265 W MARKET ST SUITE 632
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City | FAIRLAWN
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State | OH
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Zip | 44333-3337
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Country | US
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Telephone | 330-864-8379
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Fax | 330-864-8399
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Provider Business Mailing Address
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Address Line | 3265 W MARKET ST SUITE 632
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City | FAIRLAWN
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State | OH
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Zip | 44333-3337
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Country | US
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Telephone | 330-864-8379
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Fax | 330-864-8399
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MATTHEW ALLEN
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Credential | OD
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Telephone | 330-864-8379
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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 | 5010 1887
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License Number State | OH
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