NPI 1003511098
Andre Willis, LDONCLE
Practice location
- Address
- 250 Tallmadge Rd, Kent, OH 44240-7204
- Phone
- (330) 673-3516
- Fax
- (330) 673-3538
Registered specialties
Optician
Primary
Registry record
- NPI
- 1003511098
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 31 Mar 2023
- Record last updated
- 31 Mar 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.