Provider Demographics
NPI:1205024908
Name:IN SIGHT LOW VISION SERVICES LLC
Entity type:Organization
Organization Name:IN SIGHT LOW VISION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:479-244-6271
Mailing Address - Street 1:601 COUNTY ROAD 155
Mailing Address - Street 2:
Mailing Address - City:EUREKA SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72632-9229
Mailing Address - Country:US
Mailing Address - Phone:479-244-6271
Mailing Address - Fax:866-276-6904
Practice Address - Street 1:601 COUNTY ROAD 155
Practice Address - Street 2:
Practice Address - City:EUREKA SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72632-9229
Practice Address - Country:US
Practice Address - Phone:479-244-6271
Practice Address - Fax:866-276-6904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-07
Last Update Date:2007-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation