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General NPI Number Information
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NPI Number | 1457618621
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Entity Type | Organization
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Legal Business Name | EYE 2 EYE VISION CENTER PC
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 12/17/2012
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Provider Practice Location Address
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Address Line | 2537 PLAINFIELD RD
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City | JOLIET
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State | IL
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Zip | 60435-1463
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Country | US
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Telephone | 815-577-2020
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Fax | 815-577-0998
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Provider Business Mailing Address
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Address Line | 2537 PLAINFIELD RD
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City | JOLIET
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State | IL
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Zip | 60435-1463
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Country | US
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Telephone | 815-577-2020
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Fax | 815-577-0998
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JAMES CUTLER
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Credential | O.D.
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Telephone | 815-729-9143
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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 | 046009198
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046009118
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License Number State | IL
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