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General NPI Number Information
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NPI Number | 1649592635
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Entity Type | Organization
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Legal Business Name | AIM VISION CENTER INC
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 7101 CEDAR SPRINGS BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40291-2587
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Country | US
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Telephone | 502-231-8592
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Fax |
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Provider Business Mailing Address
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Address Line | 7101 CEDAR SPRINGS BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40291-2587
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Country | US
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Telephone | 502-231-8592
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | IDOWU AWOSIKA
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Credential | O.D.
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Telephone | 502-231-8592
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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 | 1776DT
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License Number State | KY
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