Provider Demographics
NPI:1689371122
Name:CORDRAY, BARBARA LYNN
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:CORDRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 HEBRON RD
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-1182
Mailing Address - Country:US
Mailing Address - Phone:740-522-2553
Mailing Address - Fax:740-522-5346
Practice Address - Street 1:911 HEBRON RD
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:OH
Practice Address - Zip Code:43056-1182
Practice Address - Country:US
Practice Address - Phone:740-522-2553
Practice Address - Fax:740-522-5346
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1800X
OHOP010060SC156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician