Provider Demographics
NPI:1467042549
Name:EYE TO EYE LLC
Entity Type:Organization
Organization Name:EYE TO EYE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TEETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:181-532-5815
Mailing Address - Street 1:602 S COLFAX ST
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46580-4623
Mailing Address - Country:US
Mailing Address - Phone:815-735-8559
Mailing Address - Fax:
Practice Address - Street 1:2932 FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3914
Practice Address - Country:US
Practice Address - Phone:815-735-8559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty