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General NPI Number Information
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NPI Number | 1083037147
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Entity Type | Organization
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Legal Business Name | JL VISION, LLC
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 01/27/2014
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Provider Practice Location Address
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Address Line | 90 PLEASANT VALLEY ST SUITE 250
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City | METHUEN
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State | MA
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Zip | 01844-7212
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Country | US
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Telephone | 978-683-2020
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Fax | 978-683-2040
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Provider Business Mailing Address
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Address Line | 396 MAIN ST
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City | BOXFORD
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State | MA
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Zip | 01921-1418
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Country | US
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Telephone | 978-352-8623
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | JANETTE L LIU
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Credential | OD
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Telephone | 402-968-0886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 4736
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License Number State | MA
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