Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 5170 | OH |
NPI | 1073531067 |
---|---|
Provider Name | Dr. Michelle Bertenthal |
First Address | Mayfield Heights, OH 44124-3307 |
Second Address | Beachwood, OH 44122-1158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 22/12/2012 |