Healthcare Provider Details

I. General information

NPI: 1558431148
Provider Name (Legal Business Name): HEIGHTS EYECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 LAKE ELMO DR
BILLINGS MT
59105-3037
US

IV. Provider business mailing address

430 LAKE ELMO DR
BILLINGS MT
59105-3037
US

V. Phone/Fax

Practice location:
  • Phone: 406-252-9927
  • Fax: 406-252-6567
Mailing address:
  • Phone: 406-252-9927
  • Fax: 406-252-6567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number665
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number747
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number781
License Number StateMT
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number532
License Number StateMT

VIII. Authorized Official

Name: BRIAN EUGENE LINDE
Title or Position: PRESIDENT
Credential: O.D.
Phone: 406-252-9927