Provider Demographics
NPI:1932661758
Name:MIWS, LLC
Entity Type:Organization
Organization Name:MIWS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMIT
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:423-883-5984
Mailing Address - Street 1:600 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:ROSSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30741-2179
Mailing Address - Country:US
Mailing Address - Phone:423-883-5984
Mailing Address - Fax:
Practice Address - Street 1:1110 MARKET ST STE 113
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2894
Practice Address - Country:US
Practice Address - Phone:423-541-3792
Practice Address - Fax:423-541-3793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty