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General NPI Number Information
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NPI Number | 1003864976
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Entity Type | Organization
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Legal Business Name | VISION ASSOCIATES, INC.
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 01/28/2008
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Provider Practice Location Address
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Address Line | 223 4TH AVE
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City | SAINT ALBANS
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State | WV
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Zip | 25177-2821
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Country | US
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Telephone | 304-727-8321
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Fax | 304-727-8841
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Provider Business Mailing Address
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Address Line | PO BOX 48
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City | SAINT ALBANS
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State | WV
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Zip | 25177-0048
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Country | US
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Telephone | 304-727-8321
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Fax | 304-727-8841
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. MONTGOMERY VICKERS
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Credential | O.D.
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Telephone | 304-727-8321
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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 | 701 O.D.
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License Number State | WV
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