Provider Demographics
NPI:1679923031
Name:EYE CHECK VISION
Entity Type:Organization
Organization Name:EYE CHECK VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIS
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:GRAJALES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:484-288-0315
Mailing Address - Street 1:275 LIVE OAK LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-6759
Mailing Address - Country:US
Mailing Address - Phone:484-288-0315
Mailing Address - Fax:
Practice Address - Street 1:275 N GULPH RD
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2803
Practice Address - Country:US
Practice Address - Phone:484-288-0315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002888152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty