Provider Demographics
NPI:1962948737
Name:EAST TENNESSEE BINOCULAR VISION CENTER PLLC
Entity type:Organization
Organization Name:EAST TENNESSEE BINOCULAR VISION CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:DR
Authorized Official - First Name:MILES
Authorized Official - Middle Name:W
Authorized Official - Last Name:RHYNE
Authorized Official - Suffix:JR
Authorized Official - Credentials:O D
Authorized Official - Phone:865-437-3166
Mailing Address - Street 1:P O BOX 32367
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-2367
Mailing Address - Country:US
Mailing Address - Phone:865-437-3166
Mailing Address - Fax:865-851-9328
Practice Address - Street 1:9051 EXECUTIVE PARK DR.,
Practice Address - Street 2:STE. 400
Practice Address - City:KNOXVVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923
Practice Address - Country:US
Practice Address - Phone:865-437-3166
Practice Address - Fax:865-851-9328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN0560152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty