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General NPI Number Information
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NPI Number | 1508005877
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Entity Type | Organization
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Legal Business Name | OPTOMETRIC SERVICES, LLC
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 111 S RED BANK RD STE A
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City | EVANSVILLE
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State | IN
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Zip | 47712-6509
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Country | US
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Telephone | 812-423-4984
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Fax | 812-423-5029
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Provider Business Mailing Address
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Address Line | 111 S RED BANK RD SUITE B
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City | EVANSVILLE
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State | IN
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Zip | 47712-6526
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Country | US
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Telephone | 812-423-4984
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. CHRISTINE MARIE VERBECK
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Credential | O.D.
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Telephone | 812-423-4984
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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 | 18003218
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License Number State | IN
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