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General NPI Number Information
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NPI Number | 1689068686
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Entity Type | Organization
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Legal Business Name | DOWNTOWN EYECARE LLC.
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 03/27/2015
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Provider Practice Location Address
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Address Line | 315 LYON ST S
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City | ALBANY
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State | OR
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Zip | 97321-2810
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Country | US
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Telephone | 541-405-5608
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Fax |
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Provider Business Mailing Address
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Address Line | 315 LYON ST S
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City | ALBANY
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State | OR
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Zip | 97321-2810
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Country | US
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Telephone | 541-405-5608
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KELLY BATEY
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Credential | O.D.
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Telephone | 541-405-5608
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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 | 3304ATI
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License Number State | OR
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