Provider Demographics
NPI:1447741376
Name:EYE2EYE VISION CARE, LLC
Entity Type:Organization
Organization Name:EYE2EYE VISION CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:843-513-8722
Mailing Address - Street 1:2362 STEVENSON DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7138
Mailing Address - Country:US
Mailing Address - Phone:843-513-8722
Mailing Address - Fax:843-501-7236
Practice Address - Street 1:3525 PARK AVENUE BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466
Practice Address - Country:US
Practice Address - Phone:843-327-4000
Practice Address - Fax:843-501-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-26
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1871721910OtherOPTOMETRIST