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General NPI Number Information
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NPI Number | 1447496260
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Entity Type | Organization
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Legal Business Name | VISION OPTICAL
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 12/29/2008
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Provider Practice Location Address
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Address Line | 8635 CHERRY LN
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City | LAUREL
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State | MD
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Zip | 20707-6200
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Country | US
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Telephone | 301-483-3103
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Fax |
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Provider Business Mailing Address
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Address Line | 8635 CHERRY LN
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City | LAUREL
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State | MD
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Zip | 20707-6200
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Country | US
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Telephone | 301-483-3103
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHARON MAXINE TERRY
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Credential |
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Telephone | 301-483-3103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 152W00000X
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License Number State | MD
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