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General NPI Number Information
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NPI Number | 1033789375
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Entity Type | Organization
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Legal Business Name | VISION INNOVATION CENTERS OF PENNSYLVANIA LLC
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 2450 MEMORIAL HWY STE 6
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City | DALLAS
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State | PA
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Zip | 18612-9285
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Country | US
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Telephone | 570-675-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 703 RUTTER AVE
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City | KINGSTON
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State | PA
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Zip | 18704-4801
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Country | US
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Telephone | 410-571-8733
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARIA C SCOTT
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Credential |
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Telephone | 410-571-7998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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