Lack, Mary C

Lack, Mary C is an individual health care provider with primary practice located at 31 Conservatory Dr , Barberton OH 44203-4281. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Lack, Mary C can be contacted via phone (330) 745-4404.

Contact Information

Primary practice address
31 Conservatory Dr Barberton OH 44203-4281
Phone: (330) 745-4404
Fax: (330) 753-9162
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4364 Ohio

Profile Details

NPI number 1801882535
LBN Legal business name Lack, Mary C
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2005
Last updated Apr 8th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1801882535 NPPES
Ohio Other 341904624 TRICARE
Ohio Other 0266520001 TRICARE
Ohio Other 54450 TRICARE
Ohio Other 000000141886 TRICARE
Ohio Other 2200676 TRICARE
Ohio Other 410041657 TRICARE
Ohio Other 341904624ML TRICARE
Ohio MEDICAID 0892155 TRICARE
Ohio Other 5521525 TRICARE

Popular Providers