Provider Demographics
NPI:1538940010
Name:MATTAWAN FAMILY EYE CARE PLC
Entity type:Organization
Organization Name:MATTAWAN FAMILY EYE CARE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEIM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:269-668-5558
Mailing Address - Street 1:52883 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MATTAWAN
Mailing Address - State:MI
Mailing Address - Zip Code:49071-8309
Mailing Address - Country:US
Mailing Address - Phone:269-668-5558
Mailing Address - Fax:
Practice Address - Street 1:52883 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MATTAWAN
Practice Address - State:MI
Practice Address - Zip Code:49071-8309
Practice Address - Country:US
Practice Address - Phone:269-668-5558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty