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General NPI Number Information
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NPI Number | 1104913664
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Entity Type | Organization
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Legal Business Name | VISION FORWARD ASSOCIATION, INC.
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 10150 W NATIONAL AVE STE 100
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City | WEST ALLIS
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State | WI
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Zip | 53227-2160
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Country | US
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Telephone | 414-615-0105
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Fax | 414-238-2261
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Provider Business Mailing Address
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Address Line | 10150 W NATIONAL AVE STE 100
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City | WEST ALLIS
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State | WI
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Zip | 53227-2160
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Country | US
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Telephone | 414-615-0105
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Fax | 414-238-2261
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Authorized Official
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Title or Position | INTERIM EXECUTIVE DIRECTOR
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Name | TERRI DAVIS
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Credential |
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Telephone | 414-615-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number |
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License Number State |
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