Provider Demographics
NPI:1093553182
Name:ORCHARD EYE CLINIC LLC
Entity type:Organization
Organization Name:ORCHARD EYE CLINIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:SHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:SECHLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:417-839-7724
Mailing Address - Street 1:2420 W CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:MO
Mailing Address - Zip Code:65613-3103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1111 E CAMBRIDGE ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:MO
Practice Address - Zip Code:65613-3500
Practice Address - Country:US
Practice Address - Phone:417-839-7724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-15
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty