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General NPI Number Information
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NPI Number | 1396558334
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Entity Type | Organization
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Legal Business Name | EYEMKR LLC
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 341 BROADWAY ST STE 314
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City | CHICO
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State | CA
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Zip | 95928-5345
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Country | US
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Telephone | 530-855-0783
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Fax | 530-285-8553
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Provider Business Mailing Address
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Address Line | 341 BROADWAY ST STE 314
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City | CHICO
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State | CA
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Zip | 95928-5345
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Country | US
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Telephone | 530-855-0783
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Fax | 530-285-8553
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Authorized Official
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Title or Position | OCULARIST
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Name | DYLAN COLE BOND
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Credential |
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Telephone | 530-855-0783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1700X
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Taxonomy Name | Ocularist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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