Provider Demographics
NPI:1447964226
Name:EISEL VISION CLINIC LLC
Entity type:Organization
Organization Name:EISEL VISION CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:EISEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-277-1997
Mailing Address - Street 1:201 W LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-1103
Mailing Address - Country:US
Mailing Address - Phone:330-424-7044
Mailing Address - Fax:330-424-1805
Practice Address - Street 1:201 W LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-1103
Practice Address - Country:US
Practice Address - Phone:330-424-7044
Practice Address - Fax:330-424-1805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty