Rogue Family Eye Care
Optometrist in Grants Pass, OR. Organization (NPI-2).
NPI number1982181186
StatusActive
Last updated in NPPESFeb 24, 2022
Details
- NPI
- 1982181186
- Entity type
- Organization (NPI-2)
- Legal business name
- Rogue Family Eye Care
- Organization subpart
- No
- Enumeration date
- Jul 20, 2018
- Certification date
- Feb 24, 2022
- Last updated
- Feb 24, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 2980ATI | OR | Yes |
| 152WP0200X | Optometrist, Pediatrics | 2980ATI | OR | |
| 152WS0006X | Optometrist, Sports Vision | – | – | |
| 152WV0400X | Optometrist, Vision Therapy | 2980ATI | OR |
Practice location
853 Ne A StGrants Pass, OR 97526
Phone 541-218-9966
Mailing address
853 Ne A StGrants Pass, OR 97526-2211
Phone 541-218-9966
Authorized official
Matthew Scot Richardson
President, Optometric Physician
5414742788
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All 19 Optometrist providers in Grants Pass · All 2,537 providers in Grants Pass
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