Healthcare Provider Details

I. General information

NPI: 1790883445
Provider Name (Legal Business Name): IN TOUCH OPTICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 KEITH ST 5
CLEVELAND TN
37312
US

IV. Provider business mailing address

PO BOX 98
SIGNAL MTN TN
37377
US

V. Phone/Fax

Practice location:
  • Phone: 423-339-9937
  • Fax: 423-339-9699
Mailing address:
  • Phone: 423-339-9937
  • Fax: 423-339-9699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1201X
TaxonomyOptometric Assistant Technician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: ERIC GENE GODUCO
Title or Position: SECRETARY TREASURER
Credential:
Phone: 423-339-9937