Healthcare Provider Details
I. General information
NPI: 1154627586
Provider Name (Legal Business Name): HEALTH TRANSFORMATIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2011
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
706 W 15TH AVE
COVINGTON LA
70433-2416
US
IV. Provider business mailing address
706 W 15TH AVE
COVINGTON LA
70433-2416
US
V. Phone/Fax
- Phone: 985-892-1110
- Fax:
- Phone: 985-892-1110
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | 1057-267T |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332H00000X |
| Taxonomy | Eyewear Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
S
SILBERNAGEL
Title or Position: OWNER
Credential: OD
Phone: 985-892-1110