Healthcare Provider Details

I. General information

NPI: 1205974334
Provider Name (Legal Business Name): VISION THERAPY CENTER OF CHARLOTTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3686 CENTER CIRCLE
FORT MILL SC
29715-9733
US

IV. Provider business mailing address

458 CRANBORNE CHASE
FORT MILL SC
29708-7922
US

V. Phone/Fax

Practice location:
  • Phone: 803-802-7171
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number1323
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number1323
License Number StateSC

VIII. Authorized Official

Name: DR. STEVEN L HALEO
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 803-802-7171