Healthcare Provider Details

I. General information

NPI: 1457755423
Provider Name (Legal Business Name): INVISION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2703 BROADBENT PKWY NE STE J
ALBUQUERQUE NM
87107-1626
US

IV. Provider business mailing address

2703 BROADBENT PKWY NE STE J
ALBUQUERQUE NM
87107-1626
US

V. Phone/Fax

Practice location:
  • Phone: 505-341-2020
  • Fax: 505-286-6152
Mailing address:
  • Phone: 505-341-2020
  • Fax: 505-286-6152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number901
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberNM505
License Number StateNM

VIII. Authorized Official

Name: DR. MICHELLE SARA COHEN
Title or Position: OWNER/OPTOMETRIST
Credential: OD
Phone: 505-341-2020