Provider Demographics
NPI:1659763027
Name:BRIGHT EYES VISION, LLC
Entity Type:Organization
Organization Name:BRIGHT EYES VISION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-404-7094
Mailing Address - Street 1:1230 OLD YORK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HARTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2030
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1230 OLD YORK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HARTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18974-2030
Practice Address - Country:US
Practice Address - Phone:814-404-7094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002480152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty