Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Andre Willis Sr., LDO/NCLE

Individual provider Optician · NPI 1003511098

Andre Willis Sr., LDO/NCLE is an Optician in Kent, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2023

Practice location Address checks out

250 Tallmadge Rd
Kent, OH 44240-7204
Phone: (330) 673-3516
Fax: (330) 673-3538
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optician (primary) Taxonomy 156FX1800X · Licence OP.006709-SC (OH)

Record details

NPI number1003511098
Entity typeIndividual (Type 1)
GenderMale
Credentials LDO/NCLE
Sole proprietorYes
NPI enumeratedMarch 31, 2023
Last updated in NPPESMarch 31, 2023
Certification dateMarch 31, 2023
Mailing address250 Tallmadge Rd, Kent, OH 44240-7204

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