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General NPI Number Information
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NPI Number | 1750340600
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Entity Type | Organization
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Legal Business Name | 20-20 EYECARE AND VISION CENTER, INC
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 106 MILHEIM DR
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City | BUTLER
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State | PA
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Zip | 16001-1515
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Country | US
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Telephone | 724-282-3265
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Fax | 724-282-2415
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Provider Business Mailing Address
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Address Line | 106 MILHEIM DR
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City | BUTLER
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State | PA
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Zip | 16001-1515
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Country | US
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Telephone | 724-282-3265
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Fax | 724-282-2415
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. LARRY HENRY
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Credential | O.D.
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Telephone | 724-282-3265
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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 | OE004850P
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License Number State | PA
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