Healthcare Provider Details

I. General information

NPI: 1528588001
Provider Name (Legal Business Name): VIZIONZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 HANCOCK RD
PETERBOROUGH NH
03458-1110
US

IV. Provider business mailing address

70 HANCOCK RD
PETERBOROUGH NH
03458-1110
US

V. Phone/Fax

Practice location:
  • Phone: 603-213-3896
  • Fax:
Mailing address:
  • Phone: 603-213-3896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number2143
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number2143
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. BRENDAN BOHL
Title or Position: OWNER
Credential: ABOC, RDO
Phone: 603-213-3896