Organization Name: | FAMILY EYE CARE OF SYLACAUGA LLC |
NPI Number: | 1003251653 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STACY LEEANN CANTLEY (OPTOMETRIST) |
Mailing Address: | 493 W 3rd St Sylacauga |
State: | AL US |
Postal Code: | 351501916 |
Phone Number: | 2562457696 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2013 |
NPI Last Update Date: | 05/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | S-C54-TA-889 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |