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General NPI Number Information
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NPI Number | 1962948737
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Entity Type | Organization
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Legal Business Name | EAST TENNESSEE BINOCULAR VISION CENTER PLLC
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Dates
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Enumeration Date | 01/17/2017
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Last Update Date | 01/17/2017
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Provider Practice Location Address
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Address Line | 9051 EXECUTIVE PARK DR., STE. 400
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City | KNOXVVILLE
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State | TN
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Zip | 37923
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Country | US
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Telephone | 865-437-3166
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Fax | 865-851-9328
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Provider Business Mailing Address
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Address Line | P O BOX 32367
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City | KNOXVILLE
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State | TN
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Zip | 37930-2367
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Country | US
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Telephone | 865-437-3166
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Fax | 865-851-9328
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Authorized Official
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Title or Position | SOLE MBR
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Name | DR. MILES W RHYNE JR.
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Credential | O. D.
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Telephone | 865-437-3166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | TN0560
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License Number State | TN
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