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General NPI Number Information
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NPI Number | 1932504164
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Entity Type | Organization
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Legal Business Name | VANCIL VISION CARE
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Dates
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Enumeration Date | 10/30/2014
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 165 US ROUTE 1
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City | BUCKSPORT
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State | ME
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Zip | 04416-4123
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Country | US
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Telephone | 207-469-3022
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Fax |
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Provider Business Mailing Address
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Address Line | 165 US ROUTE 1
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City | BUCKSPORT
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State | ME
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Zip | 04416-4123
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Country | US
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Telephone | 207-469-3022
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SONDRA VIGER
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Credential |
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Telephone | 207-469-3022
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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 | ME0839
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License Number State | ME
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