Provider Demographics
NPI:1689274516
Name:SOAVE EYE CARE PLLC
Entity Type:Organization
Organization Name:SOAVE EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SOAVE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:231-947-6767
Mailing Address - Street 1:1040 S GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-3434
Mailing Address - Country:US
Mailing Address - Phone:231-947-6767
Mailing Address - Fax:231-947-4988
Practice Address - Street 1:522 S GARFIELD AVE STE A
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-3485
Practice Address - Country:US
Practice Address - Phone:231-947-9500
Practice Address - Fax:231-947-2767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-29
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty