Provider Demographics
NPI:1821867649
Name:AECC LLC
Entity Type:Organization
Organization Name:AECC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLLIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-902-4239
Mailing Address - Street 1:11396 CHERRY BLOSSOM EAST DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-2440
Mailing Address - Country:US
Mailing Address - Phone:317-902-4239
Mailing Address - Fax:
Practice Address - Street 1:10967 ALLISONVILLE RD STE 120
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2634
Practice Address - Country:US
Practice Address - Phone:317-902-4239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty