Healthcare Provider Details

I. General information

NPI: 1932345089
Provider Name (Legal Business Name): CENTER FOR VISION AND SENSORY INTEGRATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2008
Last Update Date: 12/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 AIRPORT RD
HOT SPRINGS AR
71913-7951
US

IV. Provider business mailing address

203 FAWN ST
HOT SPRINGS AR
71901-4928
US

V. Phone/Fax

Practice location:
  • Phone: 501-767-0602
  • Fax:
Mailing address:
  • Phone: 501-538-6068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number2387
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number2387
License Number StateAR

VIII. Authorized Official

Name: DR. ANGELA FINLEY ROSE
Title or Position: PRESIDENT
Credential: O.D.
Phone: 501-538-6068