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General NPI Number Information
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NPI Number | 1689350407
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Entity Type | Organization
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Legal Business Name | ICARE VISION LLC
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 567 E 3RD ST
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-5316
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Country | US
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Telephone | 570-898-2884
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Fax |
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Provider Business Mailing Address
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Address Line | 3 S MARKET ST
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City | SELINSGROVE
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State | PA
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Zip | 17870-1845
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Country | US
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Telephone | 570-898-2884
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBERT LAMONT
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Credential |
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Telephone | 570-898-2884
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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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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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