Provider Demographics
NPI:1508197351
Name:TEICHMILLER VISION SERVICES LLC
Entity Type:Organization
Organization Name:TEICHMILLER VISION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:D
Authorized Official - Last Name:TEICHMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-353-1871
Mailing Address - Street 1:823 6TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-3021
Mailing Address - Country:US
Mailing Address - Phone:256-353-1871
Mailing Address - Fax:
Practice Address - Street 1:823 6TH AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-3021
Practice Address - Country:US
Practice Address - Phone:256-353-1871
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-718-TA-087152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty