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General NPI Number Information
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NPI Number | 1487627030
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Entity Type | Organization
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Legal Business Name | EYECARE PROFESSIONALS - MOUNTAIN EYEWEAR
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Dates
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Enumeration Date | 02/13/2006
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 305 W PARK ST
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City | LIVINGSTON
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State | MT
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Zip | 59047
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Country | US
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Telephone | 406-222-0250
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Fax | 406-222-8419
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Provider Business Mailing Address
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Address Line | PO BOX 680 305 W PARK ST
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City | LIVINGSTON
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State | MT
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Zip | 59047
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Country | US
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Telephone | 406-222-0250
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Fax | 406-222-8419
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES J BARNEY
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Credential | OD
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Telephone | 406-222-0250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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