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General NPI Number Information
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NPI Number | 1487816302
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Entity Type | Organization
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Legal Business Name | RAVALLI FAMILY EYE CARE, PC
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Dates
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Enumeration Date | 07/01/2008
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 1031 MAIN ST
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City | CORVALLIS
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State | MT
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Zip | 59828-9374
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Country | US
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Telephone | 406-363-1530
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 MAIN ST
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City | CORVALLIS
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State | MT
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Zip | 59828-9374
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Country | US
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Telephone | 406-363-1530
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN D. HUTCHISON
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Credential | OD
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Telephone | 406-363-1530
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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 | 599OPT
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License Number State | MT
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