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General NPI Number Information
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NPI Number | 1528466836
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Entity Type | Organization
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Legal Business Name | TOTAL EYE CARE, LLC
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Dates
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Enumeration Date | 12/18/2014
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 1105 E CHEROKEE AVE
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City | SALLISAW
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State | OK
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Zip | 74955-5035
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Country | US
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Telephone | 918-775-4524
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 E CHEROKEE AVE
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City | SALLISAW
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State | OK
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Zip | 74955-5035
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Country | US
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Telephone | 918-775-4524
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Fax | 918-775-4992
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | AMANDA HATCHER
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Credential | O.D.
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Telephone | 918-775-4524
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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 | 2584
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License Number State | OK
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