Healthcare Provider Details

I. General information

NPI: 1891000758
Provider Name (Legal Business Name): VISION VALUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 N FAIRFIELD RD SUITE A
BEAVERCREEK OH
45431-1711
US

IV. Provider business mailing address

1615 S CONGRESS AVE STE 105
DELRAY BEACH FL
33445-6326
US

V. Phone/Fax

Practice location:
  • Phone: 937-429-7800
  • Fax: 561-828-8367
Mailing address:
  • Phone: 561-275-2020
  • Fax: 561-275-2002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1803
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: KIRSTEN PIPHER CANTRELL
Title or Position: MANAGER OF HEALTH SERVICES
Credential:
Phone: 561-208-8464