Healthcare Provider Details

I. General information

NPI: 1588760664
Provider Name (Legal Business Name): HENLEY VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 LOGAN ST SUITE 100
NOBLESVILLE IN
46060-1557
US

IV. Provider business mailing address

341 LOGAN ST SUITE 100
NOBLESVILLE IN
46060-1557
US

V. Phone/Fax

Practice location:
  • Phone: 317-773-5555
  • Fax: 317-773-6200
Mailing address:
  • Phone: 317-773-5555
  • Fax: 317-773-6200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. ANNE E HENLEY
Title or Position: OWNER
Credential: MD
Phone: 317-773-5555