Basic Information
| Provider Information | |||||||||
| NPI: | 1205997178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VETTER | ||||||||
| FirstName: | MELISSA | ||||||||
| MiddleName: | RUTAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2118 ARLINGTON AVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432214314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142732020 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2118 ARLINGTON AVE | ||||||||
| Address2: | |||||||||
| City: | UPPER ARLINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432214314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144871022 | ||||||||
| FaxNumber: | 6144871030 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2006 | ||||||||
| LastUpdateDate: | 09/12/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 4045 | OH | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.