Healthcare Provider Details
I. General information
NPI: 1720884885
Provider Name (Legal Business Name): INVISION MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2025
Last Update Date: 02/20/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
303 FIRST STREET
CHARLEROI PA
15022-1427
US
IV. Provider business mailing address
303 FIRST STREET
CHARLEROI PA
15022-1427
US
V. Phone/Fax
- Phone: 724-483-3675
- Fax: 724-483-0404
- Phone: 724-483-3675
- Fax: 724-483-0404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
ROBERT
MARTINELLI
Title or Position: OWNER
Credential: OD
Phone: 724-483-3675