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General NPI Number Information
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NPI Number | 1053601021
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Entity Type | Organization
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Legal Business Name | MOUNTAIN VIEW EYECARE, PA
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 04/12/2011
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Provider Practice Location Address
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Address Line | 140 MAIN ST
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City | BETHEL
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State | ME
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Zip | 04217-0955
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Country | US
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Telephone | 207-824-2227
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Fax | 207-364-2237
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Provider Business Mailing Address
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Address Line | PO BOX 955
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City | BETHEL
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State | ME
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Zip | 04217-0955
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Country | US
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Telephone | 207-824-2227
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Fax | 207-364-2237
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Authorized Official
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Title or Position | OWNER
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Name | DR. PETER EVERETT
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Credential | O.D.
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Telephone | 207-364-4491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT721
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License Number State | ME
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