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General NPI Number Information
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NPI Number | 1215230495
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Entity Type | Organization
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Legal Business Name | MBS ENVISION, INC
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Dates
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Enumeration Date | 12/10/2010
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Last Update Date | 12/10/2010
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Provider Practice Location Address
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Address Line | 2707 COUNTY ROAD 350 E
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City | MAHOMET
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State | IL
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Zip | 61853-9734
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Country | US
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Telephone | 217-897-6655
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Fax | 217-897-6999
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Provider Business Mailing Address
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Address Line | 2707 COUNTY ROAD 350 E
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City | MAHOMET
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State | IL
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Zip | 61853-9734
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Country | US
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Telephone | 217-897-6655
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Fax | 217-897-6999
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | MR. ANDY CAZZOLLI
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Credential |
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Telephone | 330-923-3502
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235500000X
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Taxonomy Name | Speech/Language/Hearing Specialist/Technologist
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License Number |
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License Number State |
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