Provider Demographics
NPI:1275426025
Name:WELLFORD EYE CENTER PLLC
Entity type:Organization
Organization Name:WELLFORD EYE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CORBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLFORD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:262-844-9736
Mailing Address - Street 1:1425 W MAIN ST UNIT B
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3283
Mailing Address - Country:US
Mailing Address - Phone:406-586-2173
Mailing Address - Fax:
Practice Address - Street 1:1425 W MAIN ST UNIT B
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3283
Practice Address - Country:US
Practice Address - Phone:406-586-2173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty