Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 152W00000X | Optometrist | | 3294 T1659 | OHIO | Yes |
| 2 | 152WP0200X | Optometrist | Pediatrics | 3294 T1659 | OHIO | No |
| 3 | 152WS0006X | Optometrist | Sports Vision | 3294 T1659 | OHIO | No |
| 4 | 152WV0400X | Optometrist | Vision Therapy | 3294 T1659 | OHIO | No |