Healthcare Provider Details

I. General information

NPI: 1215312459
Provider Name (Legal Business Name): VISION PRO II, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4920 GRAND AVE
DULUTH MN
55807-2604
US

IV. Provider business mailing address

4920 GRAND AVE
DULUTH MN
55807-2604
US

V. Phone/Fax

Practice location:
  • Phone: 218-728-6211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: JAMIE L HOPP
Title or Position: VP OPERATIONS
Credential:
Phone: 715-392-6222