Provider Demographics
NPI:1073090635
Name:PROGRESS EYECARE LLC
Entity Type:Organization
Organization Name:PROGRESS EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:YATES
Authorized Official - Middle Name:H
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-802-6088
Mailing Address - Street 1:8011 CLAYTON RD STE 209
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1156
Mailing Address - Country:US
Mailing Address - Phone:314-802-6088
Mailing Address - Fax:314-433-5024
Practice Address - Street 1:8011 CLAYTON RD STE 209
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-1156
Practice Address - Country:US
Practice Address - Phone:314-802-6088
Practice Address - Fax:314-433-5024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-25
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty