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General NPI Number Information
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NPI Number | 1003976622
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Entity Type | Organization
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Legal Business Name | VISIONQUEST EYECARE
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 09/10/2007
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Provider Practice Location Address
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Address Line | 4014 CENTER RD
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City | BRUNSWICK
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State | OH
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Zip | 44212
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Country | US
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Telephone | 330-225-1254
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Fax | 330-225-2033
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Provider Business Mailing Address
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Address Line | 4014 CENTER RD
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City | BRUNSWICK
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State | OH
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Zip | 44212
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Country | US
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Telephone | 330-225-1254
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Fax | 330-225-2033
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. F. TODD PERZY
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Credential | O.D.
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Telephone | 330-225-1254
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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 | 5407
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License Number State | OH
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