Provider Demographics
NPI:1235689563
Name:UNION EYE CARE
Entity Type:Organization
Organization Name:UNION EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRISTS
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-322-5461
Mailing Address - Street 1:932 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-2738
Mailing Address - Country:US
Mailing Address - Phone:937-322-5461
Mailing Address - Fax:937-717-4626
Practice Address - Street 1:932 W COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2738
Practice Address - Country:US
Practice Address - Phone:937-322-5461
Practice Address - Fax:937-717-4626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4392152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty