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Andre Willis SR., LDO/NCLE
Optician in Kent, Ohio
NPI 1003511098

Andre Willis SR. is a Optician based in Kent, OH and is specialized in Optician. Andre Willis SR. practices in Kent, OH and has the professional credentials of LDO/NCLE. The NPI Number for Andre Willis SR. is 1003511098 and holds a License No. OP.006709-SC (Ohio).

The current practice location address for Andre Willis SR. is 250 Tallmadge Rd, Kent, OH and can be reached out via phone at 330-673-3516 and via fax at 330-673-3538.

Location: 250 Tallmadge Rd, Kent, OH, 44240-7204
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003511098
Provider Name
Andre Willis SR.
Credential
LDO/NCLE
Provider Entity Type
Individual
Gender
Male
Address
250 Tallmadge Rd, Kent, OH, 44240-7204
Phone Number
330-673-3516
Fax Number
330-673-3538
Provider Enumeration Date
03/31/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
250 Tallmadge Rd
City
Kent
State
Ohio
Zip
44240-7204
Phone Number
330-673-3516
Fax Number
330-673-3538
person
Provider Business Mailing Address Details
Address
250 Tallmadge Rd
City
Kent
State
Ohio
Zip
44240-7204
Phone Number
330-673-3516
Fax Number
330-673-3538
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
OP.006709-SC (Ohio)
Definition
Definition to come...
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