Provider Demographics
NPI:1003488180
Name:FOR YOUR EYES ONLY, INC.
Entity type:Organization
Organization Name:FOR YOUR EYES ONLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:KRIESSIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-585-2020
Mailing Address - Street 1:5900 S.O.M CENTER RD.
Mailing Address - Street 2:STE 19
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094
Mailing Address - Country:US
Mailing Address - Phone:440-585-2020
Mailing Address - Fax:440-585-2044
Practice Address - Street 1:5900 S.O.M CENTER RD.
Practice Address - Street 2:STE 19
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094
Practice Address - Country:US
Practice Address - Phone:440-585-2020
Practice Address - Fax:440-585-2044
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FOR YOUR EYES ONLY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty