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NPI Code Detail

MEDICARE: EYE CARE 108, LLC

MEDICARE: EYE CARE 108, LLC
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
1152W00000XOptometrist0618001815VA

General Provider Information

NPI Number : 1689030405
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE CARE 108, LLC
Provider Business Mailing Address
First Line : 108 W 2ND AVE
Second Line :
City : FRANKLIN
State : VA
Zip : 23851-1712
Country : US
Telephone Number : 757-562-4321
Fax Number : 757-562-3378
Provider Business Practice Location Address
First Line : 108 W 2ND AVE
Second Line :
City : FRANKLIN
State : VA
Zip : 23851-1712
Country : US
Telephone Number : 757-562-4321
Fax Number : 757-562-3378
Authorized Official
Title or Position : OWNER
Name : DR. DYLAN B BELT
Credential : O.D.
Telephone Number : 757-562-4321
Provider Enumeration Date : 01/08/2016
Last Update Date : 01/08/2016

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Directions to “EYE CARE 108, LLC ” Practice Location

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