MEDICARE: ELIZABETH POLLARD LDO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician	OP017480S	OH

General Provider Information

NPI Number	:	1366146144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH POLLARD LDO

Provider Business Mailing Address
First Line	:	8451 COLERAIN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-3926
Country	:	US
Telephone Number	:	513-923-3202
Fax Number	:	513-923-3251

Provider Business Practice Location Address
First Line	:	8451 COLERAIN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45239-3926
Country	:	US
Telephone Number	:	513-923-3202
Fax Number	:	513-923-3251

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	03/28/2023

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