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General NPI Number Information
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NPI Number | 1518177492
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Entity Type | Organization
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Legal Business Name | VISION CLINICS GROUP LLC
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 7199 PEARL RD SUITE C
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City | CLEVELAND
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State | OH
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Zip | 44130-4947
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Country | US
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Telephone | 440-843-6900
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Fax | 440-886-7238
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Provider Business Mailing Address
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Address Line | 7199 PEARL RD SUITE C
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City | CLEVELAND
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State | OH
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Zip | 44130-4947
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Country | US
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Telephone | 440-843-6900
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Fax | 440-886-7238
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DONALD ANDREW KAMMER JR.
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Credential | O.D
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Telephone | 440-843-6900
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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 | 4466 T1122
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License Number State | OH
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