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General NPI Number Information
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NPI Number | 1780341289
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Entity Type | Organization
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Legal Business Name | V EYE P VISION CARE LLC
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Dates
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Enumeration Date | 11/19/2021
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Last Update Date | 11/19/2021
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Provider Practice Location Address
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Address Line | 265 BOARDMAN CANFIELD RD
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City | YOUNGSTOWN
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State | OH
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Zip | 44512-4806
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Country | US
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Telephone | 330-726-0020
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Fax |
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Provider Business Mailing Address
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Address Line | 313 SODOM HUTCHINGS RD SE
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City | VIENNA
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State | OH
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Zip | 44473-9634
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Country | US
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Telephone | 330-647-1930
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MARC A BURCHAM
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Credential | OD
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Telephone | 330-647-1930
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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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