| NPI | 1811046253 |
|---|---|
| Doing Business As | VISION CENTER 30-2617 |
| Entity Type | Organization |
| Authorized Contact | G WESLEY CRAINSHAW Provider Enrollment Specialist 479-277-1850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist Optician |
| Additional Taxonomies | 332H00000X Eyewear Supplier |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2020-08-22 |