Provider Demographics
NPI:1578935912
Name:GILTNER OPTOMETRY PC
Entity type:Organization
Organization Name:GILTNER OPTOMETRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:BRILLAN
Authorized Official - Last Name:GILTNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:765-642-1851
Mailing Address - Street 1:5333 UNDERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-3780
Mailing Address - Country:US
Mailing Address - Phone:765-642-1851
Mailing Address - Fax:765-642-3756
Practice Address - Street 1:2321 CHARLES ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46013-2762
Practice Address - Country:US
Practice Address - Phone:765-642-1851
Practice Address - Fax:765-642-3756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003714 AB152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty