person
Mr. Wilfred James Fennewald, LICENSEDOPTICIAN
Optician in Oregon, Ohio
NPI 1093790941

Wilfred James Fennewald is a Optician based in Oregon, OH and is specialized in Optician. Wilfred James Fennewald practices in Oregon, OH and has the professional credentials of LICENSEDOPTICIAN. The NPI Number for Wilfred James Fennewald is 1093790941 and holds a License No. SC2077 (Ohio).

The current practice location address for Wilfred James Fennewald is 2737 Navarre Ave Ste 204, Oregon, OH and can be reached out via phone at 419-693-3376 and via fax at 419-693-7519. You can also correspond with Wilfred James Fennewald through the mailing address at 2737 NAVARRE AVE STE 204, OREGON, OH - 43616-3276 (mailing address contact number: 419-693-3376).

Location: 2737 Navarre Ave Ste 204, Oregon, OH, 43616-3276
person
Provider Profile Details
NPI Number
1093790941
Provider Name
Wilfred James Fennewald
Credential
LICENSEDOPTICIAN
Provider Entity Type
Individual
Gender
Male
Address
2737 Navarre Ave Ste 204, Oregon, OH, 43616-3276
Phone Number
419-693-3376
Fax Number
419-693-7519
Provider Enumeration Date
12/14/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
363492 01 OH NVA
OH2077 01 OH EYEMED
0511637 05 OH
31106091100 01 OH BWC
000000155056 01 OH ANTHEM
10251 01 OH PARAMOUNT HEALTH CARE
311060911001 01 OH MEDICAL MUTUAL
15295 01 OH SPECTERA
institution
Provider Business Practice Location Address Details
Address
2737 Navarre Ave Ste 204
City
State
Zip
43616-3276
Phone Number
419-693-3376
Fax Number
419-693-7519
person
Provider Business Mailing Address Details
Address
2737 Navarre Ave Ste 204
City
State
Zip
43616-3276
Phone Number
419-693-3376
Fax Number
419-693-7519
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Contact Lens Fitter
Taxonomy
License No.
SC2077 (Ohio)
Definition
An optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact lenses to a patient based on the prescription of an optometrist or medical physician.
person
Provider's Taxonomy Details 2
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
SC2077 (Ohio)
Definition
Definition to come...
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