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General NPI Number Information
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NPI Number | 1639214828
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Entity Type | Organization
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Legal Business Name | TOTALVISION, PC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 107 LEXINGTON PLZ
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City | LEXINGTON
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State | TN
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Zip | 38351-1505
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Country | US
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Telephone | 731-968-2020
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Fax | 731-968-2866
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Provider Business Mailing Address
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Address Line | PO BOX 419
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City | LEXINGTON
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State | TN
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Zip | 38351-0419
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Country | US
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Telephone | 731-968-2020
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Fax | 731-968-2866
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID TODD GOODMAN
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Credential | O.D.
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Telephone | 731-968-2020
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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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