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General NPI Number Information
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NPI Number | 1154505063
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Entity Type | Organization
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Legal Business Name | VISUAL FX VISION CENTERS, LLC
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 10/15/2008
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Provider Practice Location Address
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Address Line | 7000 PEACH STREET
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City | ERIE
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State | PA
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Zip | 16509
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Country | US
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Telephone | 814-866-3030
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Fax | 814-464-2953
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Provider Business Mailing Address
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Address Line | 7000 PEACH STREET
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City | ERIE
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State | PA
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Zip | 16509
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Country | US
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Telephone | 814-866-3030
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Fax | 814-464-2953
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Authorized Official
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Title or Position | CEO
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Name | DOUGLAS JAMES CLOSINSKI
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Credential |
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Telephone | 518-376-6328
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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 |
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License Number State |
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