Organization
EYE CENTERS OF TENNESSEE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIK BERGVIN (COO)
(931) 456-2728
Entity
Organization
Contact information
Practice address
305 N SPRING ST, SPARTA, TN 38583-1300
(931) 836-2424
(931) 836-1314
Mailing address
15 IRIS LN, CROSSVILLE, TN 38555-7528
(931) 456-2728
(931) 456-5446
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
207W00000X
Ophthalmology Physician
—
—
Other
Enumeration date
08/21/2019
Last updated
10/21/2020
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