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General NPI Number Information
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NPI Number | 1215677505
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Entity Type | Organization
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Legal Business Name | EYE EXPRESSIONS LLC
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Dates
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Enumeration Date | 04/01/2022
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Last Update Date | 06/08/2022
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Provider Practice Location Address
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Address Line | 2840 STELZER RD
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City | COLUMBUS
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State | OH
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Zip | 43219-3133
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Country | US
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Telephone | 614-905-7727
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Fax |
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Provider Business Mailing Address
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Address Line | 2840 STELZER RD
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City | COLUMBUS
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State | OH
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Zip | 43219-3133
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Country | US
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Telephone | 614-756-0091
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Fax | 614-756-3133
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEYANA KELLEY
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Credential | OD
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Telephone | 614-756-0091
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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 |
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