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General NPI Number Information
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NPI Number | 1063872505
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Entity Type | Organization
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Legal Business Name | VALLEY VIEW VISION, P.L.L.C.
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Dates
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Enumeration Date | 02/25/2016
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 1911 W PARKER RD
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City | JONESBORO
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State | AR
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Zip | 72404-8465
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Country | US
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Telephone | 615-415-3020
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Fax |
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Provider Business Mailing Address
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Address Line | 1911 W PARKER RD
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City | JONESBORO
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State | AR
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Zip | 72404-8465
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Country | US
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Telephone | 870-273-2581
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. ANNA ELLEN LAWRENCE
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Credential | O.D.
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Telephone | 870-273-2581
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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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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2667
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License Number State | AR
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