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General NPI Number Information
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NPI Number | 1558320838
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Entity Type | Organization
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Legal Business Name | VALLEY VISION CLINIC PS
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 22 W MAIN ST
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City | WALLA WALLA
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State | WA
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Zip | 99362
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Country | US
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Telephone | 509-529-2020
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Fax | 509-529-2115
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Provider Business Mailing Address
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Address Line | PO BOX 1138
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City | WALLA WALLA
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State | WA
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Zip | 99362
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Country | US
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Telephone | 509-529-2020
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Fax | 509-529-2115
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BRENT ANTHONY DUNN
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Credential |
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Telephone | 509-529-2020
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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 |
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License Number State |
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