Healthcare Provider Details

I. General information

NPI: 1063405405
Provider Name (Legal Business Name): EOY,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3725 N HIGH ST
COLUMBUS OH
43214-3524
US

IV. Provider business mailing address

3725 N HIGH ST
COLUMBUS OH
43214-3524
US

V. Phone/Fax

Practice location:
  • Phone: 614-261-8155
  • Fax: 614-261-4504
Mailing address:
  • Phone: 614-261-8155
  • Fax: 614-261-4504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number4233/T.111
License Number StateOH

VIII. Authorized Official

Name: DR. SHERRI RENE REED
Title or Position: OWNER
Credential: O.D.
Phone: 614-261-8155