Provider Demographics
NPI:1780397075
Name:RENEWAL OPTOMETRY, LLC
Entity type:Organization
Organization Name:RENEWAL OPTOMETRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:VOLLMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-318-8791
Mailing Address - Street 1:9588 BEHNFELDT RD
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43556-9723
Mailing Address - Country:US
Mailing Address - Phone:419-318-8791
Mailing Address - Fax:419-452-0397
Practice Address - Street 1:1113 W HIGH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-1541
Practice Address - Country:US
Practice Address - Phone:419-318-8791
Practice Address - Fax:419-452-0397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty