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General NPI Number Information
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NPI Number | 1326893348
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Entity Type | Organization
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Legal Business Name | INDIANA VISION GROUP, LLC
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 882 SE GREENVILLE AVE
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City | WINCHESTER
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State | IN
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Zip | 47394-9293
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Country | US
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Telephone | 765-584-1320
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 CLUNE STUCKE RD
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City | MARIA STEIN
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State | OH
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Zip | 45860-9724
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Country | US
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Telephone | 419-852-7660
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. ADAM REICHERT
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Credential | OD
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Telephone | 419-852-7660
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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 |
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License Number State |
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