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General NPI Number Information
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NPI Number | 1659733145
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Entity Type | Organization
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Legal Business Name | INDIANAPOLIS VISION CARE LLC
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 932 S MERIDIAN ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46225-1337
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Country | US
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Telephone | 317-636-4448
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Fax | 317-636-4476
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Provider Business Mailing Address
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Address Line | 932 S MERIDIAN ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46225-1337
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Country | US
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Telephone | 317-636-4448
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Fax | 317-636-4476
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Authorized Official
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Title or Position | OWNER
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Name | COLIN CHRISTIE
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Credential | OD
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Telephone | 317-534-5141
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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 | 18003580A
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License Number State | IN
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