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General NPI Number Information
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NPI Number | 1841314846
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Entity Type | Organization
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Legal Business Name | JERSEY FAMILY VISION CARE, LTD
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Dates
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Enumeration Date | 03/17/2007
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Last Update Date | 03/11/2008
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Provider Practice Location Address
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Address Line | 1600 S STATE ST SUITE I
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City | JERSEYVILLE
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State | IL
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Zip | 62052-3620
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Country | US
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Telephone | 618-498-7581
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Fax | 618-498-7586
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Provider Business Mailing Address
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Address Line | 1600 S STATE ST SUITE I
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City | JERSEYVILLE
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State | IL
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Zip | 62052-3620
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Country | US
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Telephone | 618-498-7581
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Fax | 618-498-7586
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIE ANN STEINHAUER
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Credential | OD, FCOVD
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Telephone | 618-498-7581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy 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 | 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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