Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 26 SC | OH |
NPI | 1063415867 |
---|---|
Provider Name | Mr. Perry Epstein |
First Address | Solon, OH 44139-2664 |
Second Address | Solon, OH 44139-2664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 08/07/2007 |