Provider Demographics
NPI:1811339948
Name:D C EYE, LLC
Entity type:Organization
Organization Name:D C EYE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HEATHERLY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:423-280-0696
Mailing Address - Street 1:1815 GUNBARREL RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3130
Mailing Address - Country:US
Mailing Address - Phone:423-648-3937
Mailing Address - Fax:423-648-2043
Practice Address - Street 1:1815 GUNBARREL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3130
Practice Address - Country:US
Practice Address - Phone:423-648-3937
Practice Address - Fax:423-648-2043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier