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General NPI Number Information
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NPI Number | 1851694921
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Entity Type | Organization
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Legal Business Name | VISIONQUEST EYECARE, PC
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 1160 NORTH SR 135
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City | GREENWOOD
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State | IN
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Zip | 46142-1019
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Country | US
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Telephone | 317-865-6829
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Fax | 317-886-7655
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Provider Business Mailing Address
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Address Line | 1160 NORTH SR 135 SUITE A
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City | GREENWOOD
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State | IN
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Zip | 46142-1019
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Country | US
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Telephone | 317-865-6829
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Fax | 317-886-7655
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Authorized Official
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Title or Position | BILLING COORDINATOR
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Name | MS. JEANINE KAY SKIRVIN
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Credential |
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Telephone | 318-213-8131
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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 | 18003177A
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License Number State | IN
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