Provider Demographics
NPI:1811377740
Name:KAT STANNIS LLC
Entity Type:Organization
Organization Name:KAT STANNIS LLC
Other - Org Name:DESIGNS FOR EYES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-520-0565
Mailing Address - Street 1:1794 N OLD US 23
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7193
Mailing Address - Country:US
Mailing Address - Phone:810-632-7444
Mailing Address - Fax:
Practice Address - Street 1:1794 N OLD US 23
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-7193
Practice Address - Country:US
Practice Address - Phone:810-632-7444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty