Doctor Name: | ROBERT MOCKABEE |
NPI Number: | 1275955643 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LDO |
License Number: | S3668 |
Business Practice Address: | 4485 Glenview Rd Warrensville Heights, OH - 441283529 |
Business Phone Number: | 2166458578 |
Business Fax Number: | |
Mailing Address: | 4485 Glenview Rd, WARRENSVILLE HEIGHTS |
State: | OH |
Postal Code: | 441283529 |
Phone Number: | 2166458578 |
Fax Number: | |
NPI Enumeration Date: | 01/20/2014 |
NPI Last Update Date: | 01/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | S3668 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |