Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0801X | Contact Lens Fitter | ||
Y | 156FX1800X | Optician |
NPI | 1396918470 |
---|---|
Provider Name | Francis Edward Petrus |
First Address | Englewood, OH 45322-2657 |
Second Address | Dayton, OH 45409-2698 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2008 |
Last Update Date | 09/04/2008 |