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General NPI Number Information
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NPI Number | 1316318280
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Entity Type | Organization
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Legal Business Name | OM VISION SERVICES INC,
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Dates
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Enumeration Date | 10/16/2015
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Last Update Date | 05/27/2021
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Provider Practice Location Address
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Address Line | 2300 BERNADETTE DR
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City | COLUMBIA
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State | MO
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Zip | 65203-4607
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Country | US
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Telephone | 417-881-5530
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 BERNADETTE DR
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City | COLUMBIA
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State | MO
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Zip | 65203-4607
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Country | US
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Telephone | 417-881-5530
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Fax |
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Authorized Official
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Title or Position | REG MANAGER
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Name | LAURA LEANN CROSS
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Credential |
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Telephone | 417-881-5530
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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 | 17822
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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