Eyecare Center, LLC

NPI #1003082058 in Martin, Tennessee

Provider Information

NPI Number: 1003082058
Entity Type: Organization
Organization Name: Eyecare Center, LLC
Primary Specialty: Optometrist
Enumeration Date: Apr 30, 2008
Last Updated: Nov 20, 2009

Practice Location

Address: 107 KENNEDY DR
City: Martin
State: Tennessee
ZIP Code: 38237-3309
Phone: (731) 587-3555

Authorized Official

Name: DR. RUSSELL MOSS GILLIAM, O.D.
Title: OPTOMETRIST
Phone: (731) 587-3555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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