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General NPI Number Information
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NPI Number | 1730617200
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Entity Type | Organization
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Legal Business Name | IVISION ASSOCIATES
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 02/15/2023
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Provider Practice Location Address
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Address Line | 1569 HAZEL ST
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City | FORT MILL
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State | SC
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Zip | 29708-0029
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Country | US
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Telephone | 224-848-9385
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Fax |
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Provider Business Mailing Address
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Address Line | 9700 REDSTONE DR STE 300
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City | INDIAN LAND
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State | SC
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Zip | 29707-5409
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Country | US
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Telephone | 803-548-3937
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | BHUMIKA PATEL
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Credential | OD
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Telephone | 224-848-9385
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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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