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General NPI Number Information
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NPI Number | 1336306646
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Entity Type | Organization
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Legal Business Name | VISION MAGIC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 1369 BEVILLE RD
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City | DAYTONA BEACH
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State | FL
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Zip | 32119-1529
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Country | US
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Telephone | 386-767-2020
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Fax | 386-761-8210
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Provider Business Mailing Address
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Address Line | 1369 BEVILLE RD
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City | DAYTONA BEACH
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State | FL
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Zip | 32119-1529
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Country | US
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Telephone | 386-767-2020
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Fax | 386-761-8210
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Authorized Official
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Title or Position | OWNER
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Name | MR. HARRY ROWLEY
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Credential | D.O.
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Telephone | 386-767-2020
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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 | DO2818
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License Number State | FL
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