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General NPI Number Information
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NPI Number | 1093981060
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Entity Type | Organization
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Legal Business Name | ACCU VISION CENTER, INC
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 235 QUEEN ST
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City | SOUTHINGTON
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State | CT
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Zip | 06489-1915
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Country | US
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Telephone | 860-628-4711
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Fax | 860-628-2242
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Provider Business Mailing Address
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Address Line | 235 QUEEN ST
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City | SOUTHINGTON
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State | CT
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Zip | 06489-1915
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Country | US
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Telephone | 860-628-4711
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Fax | 860-628-2242
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MICHAEL S MCAVOY
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Credential | O.D.
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Telephone | 860-628-4711
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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 | 1094
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License Number State | CT
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