Healthcare Provider Details

I. General information

NPI: 1427191907
Provider Name (Legal Business Name): FALMOUTH VISION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 12/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 US ROUTE ONE
FALMOUTH ME
04105
US

IV. Provider business mailing address

204 US ROUTE ONE
FALMOUTH ME
04105
US

V. Phone/Fax

Practice location:
  • Phone: 207-781-2600
  • Fax: 207-781-7299
Mailing address:
  • Phone: 207-781-2600
  • Fax: 207-781-7299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: KELLY L BELLEVUE
Title or Position: BUSINESS MANAGER
Credential:
Phone: 207-781-2600