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General NPI Number Information
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NPI Number | 1457924607
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Entity Type | Organization
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Legal Business Name | KRF VISION LLC
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 07/23/2021
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Provider Practice Location Address
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Address Line | 212 OUTLET WAY
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City | GREENBURG
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State | PA
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Zip | 15650
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Country | US
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Telephone | 724-837-7810
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Fax |
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Provider Business Mailing Address
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Address Line | 212 OUTLET WAY
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City | GREENBURG
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State | PA
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Zip | 15650
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Country | US
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Telephone | 724-837-7810
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KEITH R FULTON
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Credential |
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Telephone | 724-244-6984
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1202X
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Taxonomy Name | Optometric Technician
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License Number |
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License Number State |
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