Provider Demographics
NPI:1639316516
Name:VEACH & ALLEN PC
Entity Type:Organization
Organization Name:VEACH & ALLEN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:VEACH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:231-723-9911
Mailing Address - Street 1:384 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MANISTEE
Mailing Address - State:MI
Mailing Address - Zip Code:49660-1751
Mailing Address - Country:US
Mailing Address - Phone:231-723-9911
Mailing Address - Fax:231-723-9914
Practice Address - Street 1:384 1ST ST
Practice Address - Street 2:
Practice Address - City:MANISTEE
Practice Address - State:MI
Practice Address - Zip Code:49660-1751
Practice Address - Country:US
Practice Address - Phone:231-723-9911
Practice Address - Fax:231-723-9914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-14
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0273990001Medicare NSC