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General NPI Number Information
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NPI Number | 1275617227
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Entity Type | Organization
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Legal Business Name | LIGHT AND VISION, INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 754 MAIN STREET
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City | GARDENDALE
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State | AL
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Zip | 35071-2696
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Country | US
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Telephone | 205-631-7700
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Fax | 205-631-0990
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Provider Business Mailing Address
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Address Line | PO BOX 1919
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City | GARDENDALE
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State | AL
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Zip | 35071-1919
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JAMES FORTE
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Credential |
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Telephone | 205-631-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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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 | 152WS0006X
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Taxonomy Name | Sports Vision Optometrist
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License Number |
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License Number State |
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Taxonomy #3
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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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