Provider Demographics
NPI:1023634847
Name:LAUTZ, ESTHER (OD)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:LAUTZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 SMITH RD
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2793
Mailing Address - Country:US
Mailing Address - Phone:513-631-8889
Mailing Address - Fax:
Practice Address - Street 1:4600 SMITH RD
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2793
Practice Address - Country:US
Practice Address - Phone:513-631-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006899152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist