Provider Demographics
NPI:1154471845
Name:BRUCE W PRATTE AND DANI
Entity Type:Organization
Organization Name:BRUCE W PRATTE AND DANI
Other - Org Name:SPRINGFIELD EYECARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:PRATTE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-322-6411
Mailing Address - Street 1:1674 N LIMESTONE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-2652
Mailing Address - Country:US
Mailing Address - Phone:937-322-6411
Mailing Address - Fax:
Practice Address - Street 1:1674 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-2652
Practice Address - Country:US
Practice Address - Phone:937-322-6411
Practice Address - Fax:937-322-3132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0230806Medicaid
OH9296091Medicare PIN
OH0230806Medicaid