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General NPI Number Information
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NPI Number | 1932680618
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Entity Type | Organization
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Legal Business Name | CAREFREE EYECARE
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 01/26/2019
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Provider Practice Location Address
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Address Line | 3170 W CAREFREE HWY STE C3C4
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City | PHOENIX
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State | AZ
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Zip | 85086-3205
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Country | US
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Telephone | 623-444-2425
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Fax |
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Provider Business Mailing Address
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Address Line | 3170 W CAREFREE HWY STE C3C4
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City | PHOENIX
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State | AZ
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Zip | 85086-3205
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Country | US
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Telephone | 623-444-2425
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE MEMBER
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Name | DR. SHAWN GIESE
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Credential | O.D.
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Telephone | 623-444-2425
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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 | 1449
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License Number State | AZ
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