Provider Demographics
NPI:1417227604
Name:GILICH ENTERPRISES, LLC
Entity Type:Organization
Organization Name:GILICH ENTERPRISES, LLC
Other - Org Name:VISUALEYES CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHNEEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:GILICH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:228-627-9838
Mailing Address - Street 1:4253 DENNY AVE
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39581-5502
Mailing Address - Country:US
Mailing Address - Phone:228-627-9838
Mailing Address - Fax:228-762-4658
Practice Address - Street 1:4253 DENNY AVE
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5502
Practice Address - Country:US
Practice Address - Phone:228-627-9838
Practice Address - Fax:228-762-4658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty