Provider Demographics
NPI:1760668495
Name:MILLIKEN EYECARE
Entity Type:Organization
Organization Name:MILLIKEN EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:G
Authorized Official - Last Name:MILLIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:781-544-0000
Mailing Address - Street 1:7 NEW DRIFTWAY
Mailing Address - Street 2:
Mailing Address - City:SCITUATE
Mailing Address - State:MA
Mailing Address - Zip Code:02066-4534
Mailing Address - Country:US
Mailing Address - Phone:781-544-0000
Mailing Address - Fax:
Practice Address - Street 1:7 NEW DRIFTWAY
Practice Address - Street 2:
Practice Address - City:SCITUATE
Practice Address - State:MA
Practice Address - Zip Code:02066-4534
Practice Address - Country:US
Practice Address - Phone:781-544-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3876152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty