| Organization Name: | OHIO EYE OPTOMETRIC, LLC |
| NPI Number: | 1619018090 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MIKE A GRAHAM (CEO) |
| Mailing Address: | 58 W High St Mount Gilead |
| State: | OH US |
| Postal Code: | 433381213 |
| Phone Number: | 4199478330 |
| Fax Number: | 4199478355 |
| NPI Enumeration Date: | 02/09/2007 |
| NPI Last Update Date: | 03/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | 3826 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |