Provider Demographics
NPI:1043737943
Name:WILLS EYE OPTICAL TWO, LLC
Entity Type:Organization
Organization Name:WILLS EYE OPTICAL TWO, LLC
Other - Org Name:WILLSEYEWEAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:P
Authorized Official - Last Name:BILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-440-3150
Mailing Address - Street 1:840 WALNUT ST STE 1230
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5109
Mailing Address - Country:US
Mailing Address - Phone:215-928-3400
Mailing Address - Fax:
Practice Address - Street 1:800 ARCH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-3188
Practice Address - Country:US
Practice Address - Phone:215-928-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF PHILA TRUSTEE ACTING BY THE BRD OF DIR OF CITY TRUSTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty