Provider Demographics
NPI:1326410085
Name:20/15 EYECARE, LLC
Entity Type:Organization
Organization Name:20/15 EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:GINA
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:678-557-6727
Mailing Address - Street 1:2090 DUNWOODY CLUB DR
Mailing Address - Street 2:SUITE 126
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-5434
Mailing Address - Country:US
Mailing Address - Phone:770-676-7848
Mailing Address - Fax:470-246-4876
Practice Address - Street 1:2090 DUNWOODY CLUB DR
Practice Address - Street 2:SUITE 126
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-5434
Practice Address - Country:US
Practice Address - Phone:770-676-7848
Practice Address - Fax:470-246-4876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1584152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty