Provider Demographics
NPI:1407141906
Name:FRIES EYE CARE, LLC
Entity Type:Organization
Organization Name:FRIES EYE CARE, LLC
Other - Org Name:OPTIQUE FAMILY VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRIES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-335-2020
Mailing Address - Street 1:207 GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON COURT HOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43160-1711
Mailing Address - Country:US
Mailing Address - Phone:740-335-2020
Mailing Address - Fax:740-335-1025
Practice Address - Street 1:207 GLENN AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-1711
Practice Address - Country:US
Practice Address - Phone:740-335-2020
Practice Address - Fax:740-335-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-13
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5472152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty