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General NPI Number Information
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NPI Number | 1811240948
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Entity Type | Organization
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Legal Business Name | VISIONCHECK
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Dates
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Enumeration Date | 10/26/2012
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 105 LINKS CIR
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City | JONESBORO
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State | GA
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Zip | 30238-6308
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Country | US
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Telephone | 678-851-3322
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Fax | 678-519-5587
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Provider Business Mailing Address
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Address Line | 6525 TARA BLVD # 134
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City | JONESBORO
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State | GA
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Zip | 30236-1227
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Country | US
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Telephone | 678-369-8676
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Fax | 678-519-5587
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHARON C. MITCHELL
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Credential | LDO
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Telephone | 678-369-8676
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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 | OPT000884
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | LDO001188
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License Number State | GA
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