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General NPI Number Information
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NPI Number | 1457774119
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Entity Type | Organization
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Legal Business Name | VISION CRAFTERS
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Dates
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Enumeration Date | 01/30/2014
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Last Update Date | 01/30/2014
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Provider Practice Location Address
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Address Line | 13739 RIVERSIDE DR STE A
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-2417
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Country | US
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Telephone | 818-995-7989
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Fax | 818-995-7975
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Provider Business Mailing Address
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Address Line | 13739 RIVERSIDE DR STE A
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-2417
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Country | US
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Telephone | 818-995-7989
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Fax | 818-995-7975
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSANNA AVETISYAN
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Credential | OPTICIAN
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Telephone | 818-995-7989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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