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General NPI Number Information
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NPI Number | 1003638123
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Entity Type | Organization
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Legal Business Name | VT OPTOMETRY PLLC
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 18551 N 83RD AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-0501
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Country | US
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Telephone | 623-825-9680
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10966
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City | GLENDALE
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State | AZ
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Zip | 85318-0966
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VU TRUONG
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Credential | OD
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Telephone | 858-357-1824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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