Healthcare Provider Details

I. General information

NPI: 1447420534
Provider Name (Legal Business Name): VISIONS OPTIQUE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2008
Last Update Date: 02/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18291 N PIMA RD SUITE 120
SCOTTSDALE AZ
85255-5697
US

IV. Provider business mailing address

18291 N PIMA RD SUITE 120
SCOTTSDALE AZ
85255-5697
US

V. Phone/Fax

Practice location:
  • Phone: 480-515-2727
  • Fax: 480-515-2747
Mailing address:
  • Phone: 480-515-2727
  • Fax: 480-515-2747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number1375R
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1375
License Number StateAZ

VIII. Authorized Official

Name: DR. TIFFANY CLEPPER UELNER
Title or Position: OWNER
Credential: OD
Phone: 480-515-2727