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General NPI Number Information
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NPI Number | 1194778480
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Entity Type | Organization
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Legal Business Name | UNION VISION CENTER OF MANCHESTER RD, INC.
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 2355 MANCHESTER ROAD
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City | AKRON
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State | OH
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Zip | 44314-3639
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Country | US
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Telephone | 330-753-2266
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Fax | 330-753-3320
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Provider Business Mailing Address
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Address Line | 2355 MANCHESTER ROAD
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City | AKRON
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State | OH
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Zip | 44314-3639
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Country | US
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Telephone | 330-753-2266
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Fax | 330-753-3320
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Authorized Official
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Title or Position | PRESIDENT AND COO
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Name | PAMELA ANN FORSEA
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Credential | L.D.O.
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Telephone | 330-753-2266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | OH 2089SC
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 2089-SC
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License Number State | OH
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