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General NPI Number Information
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NPI Number | 1205081627
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Entity Type | Organization
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Legal Business Name | NATIONAL VISION, INC.
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Dates
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Enumeration Date | 11/26/2008
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | FT. LEWIS OPTOMETRY CLINIC BLDG. 202
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City | FT. LEWIS
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State | WA
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Zip | 98433
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Country | US
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Telephone | 253-964-4140
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Fax |
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Provider Business Mailing Address
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Address Line | 296 GRAYSON HWY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-5737
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Country | US
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Telephone | 770-822-3600
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Fax |
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Authorized Official
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Title or Position | MANAGER, MANAGED CARE SALES
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Name | CARLY SCHENCK
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Credential |
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Telephone | 678-892-3760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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