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General NPI Number Information
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NPI Number | 1558189084
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Entity Type | Organization
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Legal Business Name | LOW VISION SPECIALISTS
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 4145 S MCCANN CT STE D
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City | SPRINGFIELD
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State | MO
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Zip | 65804-7232
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Country | US
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Telephone | 417-598-0168
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Fax | 417-719-7955
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Provider Business Mailing Address
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Address Line | 4145 S MCCANN CT STE D
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City | SPRINGFIELD
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State | MO
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Zip | 65804-7232
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Country | US
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Telephone | 417-598-0168
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Fax | 417-719-7955
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Authorized Official
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Title or Position | OWNER
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Name | DR. DEBRA WILLIAMS
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Credential | OD
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Telephone | 417-598-0168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224ZL0004X
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Taxonomy Name | Low Vision Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number |
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License Number State |
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