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General NPI Number Information
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NPI Number | 1912679275
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Entity Type | Organization
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Legal Business Name | TOWN LINE EYE CARE, LLC
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 80 TOWN LINE ROAD C/O LENSCRAFTERS
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City | ROCKY HILL
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State | CT
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Zip | 06067
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Country | US
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Telephone | 860-258-2380
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Fax |
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Provider Business Mailing Address
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Address Line | 80 TOWN LINE ROAD C/O LENSCRAFTERS
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City | ROCKY HILL
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State | CT
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Zip | 06067
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Country | US
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Telephone | 860-258-2380
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MATTHEW KING
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Credential | OD
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Telephone | 860-271-6502
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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 |
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License Number State |
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