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General NPI Number Information
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NPI Number | 1013210053
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Entity Type | Organization
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Legal Business Name | VANCE & TEKNIPP EYE CARE, LLC
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Dates
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Enumeration Date | 12/14/2010
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Last Update Date | 12/14/2010
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Provider Practice Location Address
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Address Line | 602 SOUTH ST SUITE B-14
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City | CHARDON
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State | OH
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Zip | 44024-1499
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Country | US
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Telephone | 440-285-5007
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Fax | 440-285-4313
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Provider Business Mailing Address
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Address Line | 602 SOUTH ST SUITE B-14
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City | CHARDON
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State | OH
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Zip | 44024-1499
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Country | US
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Telephone | 440-285-5007
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Fax | 440-285-4313
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. TRISHA BARNES VANCE
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Credential | O.D.
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Telephone | 614-306-6294
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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 | 5578
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License Number State | OH
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