Basic Information
| Provider Information | |||||||||
| NPI: | 1225438898 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FROST | ||||||||
| FirstName: | CAROLYN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 903 TIFFIN AVE | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458405857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194234000 | ||||||||
| FaxNumber: | 4194232232 | ||||||||
| Practice Location | |||||||||
| Address1: | 903 TIFFIN AVE | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458405857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194234000 | ||||||||
| FaxNumber: | 4194232232 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2014 | ||||||||
| LastUpdateDate: | 09/02/2014 | ||||||||
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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 | 156FX1800X | S.5580 | OH | Y | Eye and Vision Services Providers | Technician/Technologist | Optician |
No ID Information.