Renaissance Ocular Disease and Trauma Foundation, Inc
Renaissance Ocular Disease and Trauma Foundation, Inc is an Optometrist in Lagrange, Indiana. Licensed in Indiana. Registered with an NPI since 2007.
- Licensed in
- IN
- In the registry since
- 2007
- Specialties on file
- 2
What do these letters mean?
- Inc — Incorporated
- A form of business registration, not a clinical qualification.
Practice location Address checks out
201 W Wayne StLagrange, IN 46761-1850
Phone: (260) 463-3421
Fax: (260) 463-7347
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Optometrist (primary) | Taxonomy 152W00000X · Licence 18002670A/B (IN) |
|---|---|
| Eyewear Supplier | Taxonomy 332H00000X · Licence 18002670A/B (IN) |
Record details
| NPI number | 1174740682 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Ricky Weidow — President · (260) 463-3421 |
| Other names | Evergreen Eye Clinic |
| NPI enumerated | April 19, 2007 |
| Last updated in NPPES | February 27, 2010 |
| Mailing address | 201 W Wayne St, Po Box 150, Lagrange, IN 46761-1850 |
Other providers in Lagrange
-
Dr. Ricky Lee Weidow, OD
201 W Wayne St, Lagrange, IN 46761-1850 · (260) 463-3421