Provider Demographics
NPI:1750139671
Name:HORLICK EYE CARE
Entity type:Organization
Organization Name:HORLICK EYE CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HORLICK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:919-508-7804
Mailing Address - Street 1:33 BLAIR PARK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7587
Mailing Address - Country:US
Mailing Address - Phone:802-862-1947
Mailing Address - Fax:
Practice Address - Street 1:33 BLAIR PARK RD STE 101
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-7587
Practice Address - Country:US
Practice Address - Phone:802-862-1947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty