Provider Demographics
NPI:1619224540
Name:PRATT VISION, LLC
Entity Type:Organization
Organization Name:PRATT VISION, LLC
Other - Org Name:LIFETIME EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MURRAY
Authorized Official - Middle Name:S
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-706-3060
Mailing Address - Street 1:3961 E CHANDLER BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0303
Mailing Address - Country:US
Mailing Address - Phone:480-706-3060
Mailing Address - Fax:480-706-3065
Practice Address - Street 1:3961 E CHANDLER BLVD STE 106
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0303
Practice Address - Country:US
Practice Address - Phone:480-706-3060
Practice Address - Fax:480-706-3065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1809152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty