Provider Demographics
NPI:1285192906
Name:CUTLER EYE CARE, LLC
Entity Type:Organization
Organization Name:CUTLER EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAT
Authorized Official - Middle Name:
Authorized Official - Last Name:CUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-668-0122
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-0583
Mailing Address - Country:US
Mailing Address - Phone:970-668-0122
Mailing Address - Fax:
Practice Address - Street 1:842 N SUMMIT BLVD FRISCO STATION
Practice Address - Street 2:SUITE 28
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443-8044
Practice Address - Country:US
Practice Address - Phone:970-668-0122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000170068Medicaid