Healthcare Provider Details

I. General information

NPI: 1710107925
Provider Name (Legal Business Name): VICTORY VISION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5139 CHESTNUT ST
PHILADELPHIA PA
19139-3430
US

IV. Provider business mailing address

5139 CHESTNUT ST
PHILADELPHIA PA
19139-3430
US

V. Phone/Fax

Practice location:
  • Phone: 215-747-3550
  • Fax: 215-747-3267
Mailing address:
  • Phone: 215-747-3550
  • Fax: 215-747-3267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTIAN JOYNES
Title or Position: OWNER OPTICIAN
Credential: ETC
Phone: 215-747-3550