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General NPI Number Information
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NPI Number | 1356454466
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Entity Type | Organization
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Legal Business Name | VISION SERVICES, PC
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 10/16/2018
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Provider Practice Location Address
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Address Line | 100 NORTH AVE
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City | BATTLE CREEK
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State | MI
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Zip | 49017-3417
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Country | US
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Telephone | 269-962-7595
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Fax | 269-963-9202
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Provider Business Mailing Address
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Address Line | 105 W EXCHANGE ST
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City | SPRING LAKE
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State | MI
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Zip | 49456-2024
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Country | US
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Telephone | 616-846-0620
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Fax | 616-844-6079
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Authorized Official
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Title or Position | CONTROLLER
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Name | JONATHAN WESTRA
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Credential |
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Telephone | 616-846-0620
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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 | 4901002642
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License Number State | MI
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