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General NPI Number Information
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NPI Number | 1881708238
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Entity Type | Organization
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Legal Business Name | COMMUNITY SERVICES FOR VISION REHABILITATION, INC.
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 10/29/2013
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Provider Practice Location Address
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Address Line | 600 BEL AIR BLVD SUITE 110
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City | MOBILE
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State | AL
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Zip | 36606-3511
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Country | US
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Telephone | 251-476-4744
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Fax |
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Provider Business Mailing Address
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Address Line | 600 BEL AIR BLVD SUITE 110
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City | MOBILE
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State | AL
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Zip | 36606-3511
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Country | US
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Telephone | 251-476-4744
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JOSEPH L FONTENOT
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Credential |
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Telephone | 251-476-4744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number |
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License Number State |
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