Healthcare Provider Details

I. General information

NPI: 1144577941
Provider Name (Legal Business Name): QUICK VISION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2012
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1813 WILLOW ST STE 2A
VINCENNES IN
47591
US

IV. Provider business mailing address

1813 WILLOW ST STE 2A
VINCENNES IN
47591-4276
US

V. Phone/Fax

Practice location:
  • Phone: 812-255-0559
  • Fax: 812-316-0020
Mailing address:
  • Phone: 812-255-0559
  • Fax: 812-316-0020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18003650A
License Number StateIN

VIII. Authorized Official

Name: DR. JERICHO LYNN QUICK
Title or Position: OWNER
Credential: O.D.
Phone: 812-255-0559