Provider Demographics
NPI:1386492114
Name:BLYTHE, CHRISTINE (DO)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BLYTHE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4370 EASTGATE SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-4502
Mailing Address - Country:US
Mailing Address - Phone:513-753-8490
Mailing Address - Fax:513-753-8499
Practice Address - Street 1:4370 EASTGATE SQUARE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-4502
Practice Address - Country:US
Practice Address - Phone:513-753-8490
Practice Address - Fax:513-753-8499
Is Sole Proprietor?:No
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOP.007191-SC156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician