Organization
EYECARE CENTER OPTOMETRIST PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM T REYNOLDS JR. OD (OWNER)
(859) 623-3358
Entity
Organization
Contact information
Practice address
1073 BROADWAY ST, BEATTYVILLE, KY 41311-8719
(606) 464-8148
(606) 464-0142
Mailing address
1020 GIBSON BAY DR, RICHMOND, KY 40475-3448
(859) 623-3358
(859) 623-8141
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1069DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77902518
—
KY
Enumeration date
09/19/2007
Last updated
11/10/2008
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