Provider Demographics
NPI:1780990879
Name:OPTIMAL EYE CARE LLC
Entity type:Organization
Organization Name:OPTIMAL EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUAGENTI-ENGLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:419-230-4704
Mailing Address - Street 1:6433 PULLMAN DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-7377
Mailing Address - Country:US
Mailing Address - Phone:740-548-0100
Mailing Address - Fax:740-548-2122
Practice Address - Street 1:6433 PULLMAN DR
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-7377
Practice Address - Country:US
Practice Address - Phone:740-548-0100
Practice Address - Fax:740-548-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5946152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty