=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518296748
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EYECARE FOR YOU, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/17/2009
-----------------------------------------------------
Last Update Date | 06/07/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1593 VT RT 107
-----------------------------------------------------
City | BETHEL
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-234-9728
-----------------------------------------------------
Fax | 802-234-9732
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1593 VT RT 107
-----------------------------------------------------
City | BETHEL
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-234-9728
-----------------------------------------------------
Fax | 802-234-9732
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPTOMETRIST
-----------------------------------------------------
Name | DR. DEAN A BARCELOW
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 802-234-9728
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 300000196
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------