Vision Source Marysville

NPI #1992316848 in Marysville, Ohio

Provider Information

NPI Number: 1992316848
Entity Type: Organization
Organization Name: Vision Source Marysville
Subpart: Yes (part of a larger organization)
Parent Organization: COURTNEY L POLING OD
Primary Specialty: Optometrist
Enumeration Date: Aug 13, 2020
Last Updated: May 10, 2021

Practice Location

Address: 303 W 5TH ST
City: Marysville
State: Ohio
ZIP Code: 43040-1113
Phone: (937) 644-2075

Authorized Official

Name: MRS. MALLORIE GOODRIDGE
Title: OFFICE MANAGER
Phone: (937) 644-8637

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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