| Doctor Name: | MR. EDWARD J NOWAK |
| NPI Number: | 1013109198 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LDO |
| License Number: | 2005-SC |
| Business Practice Address: | 3144 Markway Rd Toledo, OH - 436062925 |
| Business Phone Number: | 4195357683 |
| Business Fax Number: | 4195356704 |
| Mailing Address: | 3144 Markway Rd, TOLEDO |
| State: | OH |
| Postal Code: | 436062925 |
| Phone Number: | 4195357683 |
| Fax Number: | 4195356704 |
| NPI Enumeration Date: | 08/13/2007 |
| NPI Last Update Date: | 12/28/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 2005-SC |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |