Provider Demographics
NPI:1124651385
Name:RATH OPTOMETRY LLC
Entity type:Organization
Organization Name:RATH OPTOMETRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:RATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-494-5020
Mailing Address - Street 1:1174 ALLIANCE RD NW
Mailing Address - Street 2:
Mailing Address - City:MINERVA
Mailing Address - State:OH
Mailing Address - Zip Code:44657-8736
Mailing Address - Country:US
Mailing Address - Phone:330-868-0076
Mailing Address - Fax:
Practice Address - Street 1:1174 ALLIANCE RD NW
Practice Address - Street 2:
Practice Address - City:MINERVA
Practice Address - State:OH
Practice Address - Zip Code:44657-8736
Practice Address - Country:US
Practice Address - Phone:330-868-0076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center