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General NPI Number Information
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NPI Number | 1144479353
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Entity Type | Organization
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Legal Business Name | NEW VISION OPTICAL -WISE LLC
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 09/12/2008
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Provider Practice Location Address
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Address Line | 135 WISE COUNTY PLAZA
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City | WISE
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State | VA
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Zip | 24293
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Country | US
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Telephone | 276-679-5610
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3100
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City | WISE
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State | VA
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Zip | 24293-3100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTICIAN
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Name | RICK NORTON
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Credential |
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Telephone | 276-679-5610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1101001242
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License Number State | VA
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