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General NPI Number Information
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NPI Number | 1619445798
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Entity Type | Organization
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Legal Business Name | SVS VISION INC
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 06/29/2023
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Provider Practice Location Address
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Address Line | 7542 26 MILE ROAD
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City | SHELBY
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State | MI
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Zip | 48316
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Country | US
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Telephone | 586-267-9000
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Fax | 586-314-0536
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Provider Business Mailing Address
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Address Line | 118 CASS AVE
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City | MOUNT CLEMENS
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State | MI
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Zip | 48043-2204
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Country | US
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Telephone | 586-464-1479
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Fax | 586-464-1480
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Authorized Official
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Title or Position | PROFESSIONAL SERVICES MANAGER
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Name | JILL FRESHNEY
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Credential |
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Telephone | 586-464-1479
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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 |
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License Number State |
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Taxonomy #2
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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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