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General NPI Number Information
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NPI Number | 1679667166
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Entity Type | Organization
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Legal Business Name | SCHWAN VISION, LLC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 596 BOBBY JONES EXPY
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City | AUGUSTA
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State | GA
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Zip | 30907-5300
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Country | US
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Telephone | 706-863-1150
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Fax | 706-863-1195
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Provider Business Mailing Address
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Address Line | 596 BOBBY JONES EXPY
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City | AUGUSTA
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State | GA
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Zip | 30907-5300
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Country | US
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Telephone | 706-863-1150
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Fax | 706-863-1195
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CAROL ANN SCHWAN
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Credential |
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Telephone | 706-863-1150
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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 | 2077T
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License Number State | GA
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