Provider Demographics
NPI:1811291354
Name:MILLER FAMILY EYECARE, INC.
Entity type:Organization
Organization Name:MILLER FAMILY EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:319-373-3737
Mailing Address - Street 1:576 BOYSON RD NE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-7363
Mailing Address - Country:US
Mailing Address - Phone:319-373-3737
Mailing Address - Fax:
Practice Address - Street 1:576 BOYSON RD NE
Practice Address - Street 2:SUITE 104
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-7363
Practice Address - Country:US
Practice Address - Phone:319-373-3737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-24
Last Update Date:2010-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02055152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty