Provider Demographics
NPI:1720701311
Name:LANCE RITTENHOUSE LLC
Entity Type:Organization
Organization Name:LANCE RITTENHOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RITTENHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:912-265-8852
Mailing Address - Street 1:120 COMMERCE DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-1899
Mailing Address - Country:US
Mailing Address - Phone:912-265-8852
Mailing Address - Fax:912-264-4673
Practice Address - Street 1:120 COMMERCE DR STE 100
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-1899
Practice Address - Country:US
Practice Address - Phone:912-265-8852
Practice Address - Fax:912-264-4673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty