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Active Eyecare LLC

Clinic/Center in Surprise, AZ. Organization (NPI-2).

NPI number1295100204
StatusActive
Last updated in NPPESDec 2, 2015

Details

NPI
1295100204
Entity type
Organization (NPI-2)
Legal business name
Active Eyecare LLC
Organization subpart
No
Enumeration date
Dec 2, 2015
Last updated
Dec 2, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center1117AZYes

Other names

  • Active Eyecare Of Surprise (Doing Business As)

Practice location

16968 W Bell Rd
Suite 402
Surprise, AZ 85374-8943

Phone 623-214-0353 · Fax 623-214-0693

Mailing address

16968 W Bell Rd
Suite 402
Surprise, AZ 85374-8943

Phone 623-214-0353 · Fax 623-214-0693

Authorized official

Mark Edward Fechtel
Owner
6232140353

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