MEDICARE: PRECISION EYE CARE, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	2729	TN

General Provider Information

NPI Number	:	1093018897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISION EYE CARE, PLLC

Provider Business Mailing Address
First Line	:	667 S MOUNT JULIET RD
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-6483
Country	:	US
Telephone Number	:	615-758-2344
Fax Number	:	615-758-8868

Provider Business Practice Location Address
First Line	:	667 S MOUNT JULIET RD
Second Line	:
City	:	MOUNT JULIET
State	:	TN
Zip	:	37122-6483
Country	:	US
Telephone Number	:	615-758-2344
Fax Number	:	615-758-8868

Authorized Official
Title or Position	:	MEMBER
Name	:	RYAN P FRITSCH
Credential	:	O.D.
Telephone Number	:	615-758-2344

Provider Enumeration Date	:	12/16/2010
Last Update Date	:	12/16/2010

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