Healthcare Provider Details

I. General information

NPI: 1801139084
Provider Name (Legal Business Name): VALLEY EYE CARE ASSOCIATES, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2013
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 MEADOW LANE
FORT KENT ME
04743
US

IV. Provider business mailing address

29 MEADOW LANE
FORT KENT ME
04743
US

V. Phone/Fax

Practice location:
  • Phone: 207-834-3333
  • Fax: 207-834-6095
Mailing address:
  • Phone: 207-834-3333
  • Fax: 207-834-6095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY DAVID RIOUX
Title or Position: PRESIDENT
Credential:
Phone: 207-834-3333