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General NPI Number Information
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NPI Number | 1053715433
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Entity Type | Organization
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Legal Business Name | ADVANCED FAMILY EYE CARE, LLC
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 749 UNIVERSITY VILLAGE DR STE 2
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-7613
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Country | US
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Telephone | 614-425-0758
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Fax |
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Provider Business Mailing Address
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Address Line | 3940 RENNES DR
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City | COLUMBUS
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State | OH
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Zip | 43221-5690
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Country | US
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Telephone | 614-425-0758
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. TRAVIS R ZIGLER
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Credential | O.D.
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Telephone | 614-425-0758
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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 |
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License Number State | SC
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