Provider Demographics
NPI:1447452651
Name:JON T. ROMER, O.D. & ASSOCIATES, INC.
Entity type:Organization
Organization Name:JON T. ROMER, O.D. & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ROMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-584-0615
Mailing Address - Street 1:1950 HAVEMANN RD
Mailing Address - Street 2:WAL-MART VISION CENTER
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-9300
Mailing Address - Country:US
Mailing Address - Phone:419-584-0615
Mailing Address - Fax:419-584-0637
Practice Address - Street 1:1950 HAVEMANN RD
Practice Address - Street 2:WAL-MART VISION CENTER
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-9300
Practice Address - Country:US
Practice Address - Phone:419-584-0615
Practice Address - Fax:419-584-0637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4871152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty