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General NPI Number Information
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NPI Number | 1841474186
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Entity Type | Organization
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Legal Business Name | VISION SOURCE OF HENDERSONVILLE
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 02/10/2021
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Provider Practice Location Address
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Address Line | 100 COUNTRY CLUB DRIVE SUITE 106
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-4025
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Country | US
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Telephone | 615-824-4246
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Fax |
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Provider Business Mailing Address
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Address Line | 100 COUNTRY CLUB DRIVE SUITE 106
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-4025
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Country | US
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Telephone | 615-824-4246
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Fax | 800-216-3102
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | HEATHER STEFFY
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Credential |
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Telephone | 615-824-4246
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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 | 0000002721
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License Number State | TN
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