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General NPI Number Information
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NPI Number | 1124323027
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Entity Type | Organization
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Legal Business Name | VISIONSTHREE PARTNERSHIP
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Dates
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Enumeration Date | 01/24/2011
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 3313 PINE HILL CRES
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5123
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Country | US
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Telephone | 757-606-3945
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Fax | 757-606-1211
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Provider Business Mailing Address
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Address Line | 3313 PINE HILL CRES
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City | CHESAPEAKE
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State | VA
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Zip | 23321-5123
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Country | US
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Telephone | 757-606-3945
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Fax | 757-606-1211
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PHYLLIS D SPRUILL
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Credential | PCA
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Telephone | 757-606-3945
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 305S00000X
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License Number State | VA
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