| Doctor Name: | PAUL W TEKNIPP |
| NPI Number: | 1669603999 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OPTICIAN |
| License Number: | OH3414 |
| Business Practice Address: | 32001 Vine St Willowick, OH - 440953572 |
| Business Phone Number: | 4403470696 |
| Business Fax Number: | 4409440881 |
| Mailing Address: | 32001 Vine St., WILLOWICK |
| State: | OH |
| Postal Code: | 44095 |
| Phone Number: | 4403470696 |
| Fax Number: | 4409440881 |
| NPI Enumeration Date: | 08/04/2009 |
| NPI Last Update Date: | 08/04/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | OH3414 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |