Provider Demographics
NPI:1568921633
Name:EVANS, PIGGOTT & FINNEY EYE CARE GROUP VISION THERAPY CENTER, LLC
Entity Type:Organization
Organization Name:EVANS, PIGGOTT & FINNEY EYE CARE GROUP VISION THERAPY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:765-447-4951
Mailing Address - Street 1:1221 S CREASY LN STE A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47905-7430
Mailing Address - Country:US
Mailing Address - Phone:765-447-4951
Mailing Address - Fax:
Practice Address - Street 1:3652 ROME DR STE F
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4465
Practice Address - Country:US
Practice Address - Phone:765-447-3153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty