Provider Demographics
NPI:1710231709
Name:THERESA M BECHTEL, OD LLC
Entity Type:Organization
Organization Name:THERESA M BECHTEL, OD LLC
Other - Org Name:MARTINSVILLE EYECARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BECHTEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:276-732-4076
Mailing Address - Street 1:1049 BROOKDALE ST STE C
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-3972
Mailing Address - Country:US
Mailing Address - Phone:276-732-4076
Mailing Address - Fax:
Practice Address - Street 1:1049 BROOKDALE ST STE C
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-3972
Practice Address - Country:US
Practice Address - Phone:276-732-4076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001184152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty