Provider Demographics
NPI:1205477064
Name:DUAL COUNTY EYECARE LLC
Entity type:Organization
Organization Name:DUAL COUNTY EYECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:LINDEMUTH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:814-715-0747
Mailing Address - Street 1:738 FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3019
Mailing Address - Country:US
Mailing Address - Phone:814-715-0747
Mailing Address - Fax:
Practice Address - Street 1:15050 S SPRINGDALE AVE
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9211
Practice Address - Country:US
Practice Address - Phone:440-632-0530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty