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NPI 1255416137

NPI 1255416137 : VISION HEALTH CARE, INC. : FAIRMONT, WV

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General NPI Number Information
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    NPI Number           |    1255416137
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    Entity Type          |    Organization 
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    Legal Business Name  |    VISION HEALTH CARE, INC. 
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Dates
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    Enumeration Date     |    10/26/2006
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    Last Update Date     |    08/18/2014
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Provider Practice Location Address
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    Address Line         |    717 FAIRMONT AVE 
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    City                 |    FAIRMONT
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    State                |    WV
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    Zip                  |    26554-5135
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    Country              |    US
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    Telephone            |    304-366-3830
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    Fax                  |    304-366-8049
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Provider Business Mailing Address
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    Address Line         |    717 FAIRMONT AVE 
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    City                 |    FAIRMONT
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    State                |    WV
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    Zip                  |    26554-5135
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    Country              |    US
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    Telephone            |    304-366-3830
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    Fax                  |    304-366-8049
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Authorized Official
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    Title or Position    |    OWNER/PRESIDENT
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    Name                 |    DR. CHERYL COLLEEN VAN HORN 
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    Credential           |    O.D.
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    Telephone            |    304-366-3830
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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       |    853-OD
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    License Number State |    WV
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