Active Eyecare LLC

NPI #1295100204 in Surprise, Arizona

Provider Information

NPI Number: 1295100204
Entity Type: Organization
Organization Name: Active Eyecare LLC
Primary Specialty: Clinic/Center
Enumeration Date: Dec 2, 2015
Last Updated: Dec 2, 2015

Practice Location

Address: 16968 W BELL RD
Address 2: SUITE 402
City: Surprise
State: Arizona
ZIP Code: 85374-8943
Phone: (623) 214-0353

Authorized Official

Name: DR. MARK EDWARD FECHTEL, OD
Title: OWNER
Phone: (623) 214-0353

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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