Healthcare Provider Details

I. General information

NPI: 1780099580
Provider Name (Legal Business Name): VALLEY EYE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9529 W STATE ROAD 56
FRENCH LICK IN
47432-9708
US

IV. Provider business mailing address

9529 W STATE ROAD 56
FRENCH LICK IN
47432-9708
US

V. Phone/Fax

Practice location:
  • Phone: 812-936-5222
  • Fax: 812-936-5225
Mailing address:
  • Phone: 812-936-5222
  • Fax: 812-936-5225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18003699B
License Number StateIN

VIII. Authorized Official

Name: AARON KYLE COOKE
Title or Position: OWNER
Credential:
Phone: 812-936-5222