Organization Name: | SPEARFISH EYE CARE CENTER |
NPI Number: | 1144256587 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL RICHEY (OWNER) |
Mailing Address: | 1710 North Ave Spearfish |
State: | SD US |
Postal Code: | 577831218 |
Phone Number: | 6056428430 |
Fax Number: | 6056428185 |
NPI Enumeration Date: | 06/25/2006 |
NPI Last Update Date: | 09/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |