Provider Demographics
NPI:1588849772
Name:EYE TO EYE OPTOMETY, LLC
Entity Type:Organization
Organization Name:EYE TO EYE OPTOMETY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:HA
Authorized Official - Last Name:MARSHALL-UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:302-678-3932
Mailing Address - Street 1:103 WOLF CREEK BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-4915
Mailing Address - Country:US
Mailing Address - Phone:302-678-3932
Mailing Address - Fax:302-734-3596
Practice Address - Street 1:103 WOLF CREEK BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-4915
Practice Address - Country:US
Practice Address - Phone:302-678-3932
Practice Address - Fax:302-734-3596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1312152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty