Provider Demographics
NPI:1093841967
Name:TRIMBLE VISION SERVICES, LLC
Entity Type:Organization
Organization Name:TRIMBLE VISION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TRIMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:860-751-8903
Mailing Address - Street 1:35 GREEN WOODS LN
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06085-1555
Mailing Address - Country:US
Mailing Address - Phone:860-751-8903
Mailing Address - Fax:860-255-7132
Practice Address - Street 1:355 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117-2511
Practice Address - Country:US
Practice Address - Phone:860-233-2668
Practice Address - Fax:860-236-4293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002674152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty