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General NPI Number Information
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NPI Number | 1477943041
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Entity Type | Organization
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Legal Business Name | INVISION OPTICAL INC.
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Dates
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Enumeration Date | 02/03/2015
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 350 HALLMAN HL E SUITE 81
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City | HOMEWOOD
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State | AL
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Zip | 35209-6532
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Country | US
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Telephone | 205-390-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 350 HALLMAN HILL E. SUITE 81
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City | HOMEWOOD
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State | AL
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Zip | 35209
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Country | US
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Telephone | 205-390-0100
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. THEODORE WEAVER
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Credential | OPTICIAN
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Telephone | 205-390-0100
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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 | 28466
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License Number State | AL
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