Healthcare Provider Details

I. General information

NPI: 1679832083
Provider Name (Legal Business Name): FAMILY VISION CARE OF COOL SPRINGS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 05/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4085 MALLORY LN SUITE 110
FRANKLIN TN
37067-8290
US

IV. Provider business mailing address

4085 MALLORY LN SUITE 110
FRANKLIN TN
37067-8290
US

V. Phone/Fax

Practice location:
  • Phone: 615-771-2550
  • Fax: 615-771-2099
Mailing address:
  • Phone: 615-771-2550
  • Fax: 615-771-2099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. DAXX DAVID BRANDON DUNN
Title or Position: OWNER
Credential: O.D.
Phone: 615-771-2550