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General NPI Number Information
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NPI Number | 1992872451
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Entity Type | Organization
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Legal Business Name | TRI-STATE CENTERS FOR SIGHT, INC.
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1960 N BEND RD SUITE H
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City | HEBRON
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State | KY
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Zip | 41048-9125
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Country | US
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Telephone | 859-341-4525
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Fax | 859-341-4993
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Provider Business Mailing Address
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Address Line | 802 SCOTT ST SUITE 201
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City | COVINGTON
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State | KY
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Zip | 41011-2420
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Country | US
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Telephone | 859-581-7120
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Fax | 859-581-7207
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DANIEL A NORDLOH
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Credential |
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Telephone | 859-581-7120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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