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General NPI Number Information
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NPI Number | 1619049731
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Entity Type | Organization
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Legal Business Name | WEBVISION P.L.L.C.
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 12/04/2007
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Provider Practice Location Address
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Address Line | 45400 MARKETPLACE BLVD
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City | CHESTERFIELD
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State | MI
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Zip | 48051-3279
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Country | US
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Telephone | 586-421-1274
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Fax | 586-421-1274
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Provider Business Mailing Address
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Address Line | 34347 LILLIAN RD
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City | CHESTERFIELD
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State | MI
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Zip | 48047-3127
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Country | US
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Telephone | 586-725-0257
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Fax | 586-421-1274
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC CARL WEBB
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Credential | O.D.
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Telephone | 586-899-6076
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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 | 4901004113
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License Number State | MI
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