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General NPI Number Information
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NPI Number | 1932578929
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Entity Type | Organization
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Legal Business Name | SPECIAL-EYES VISION CARE, LLC
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Dates
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Enumeration Date | 09/19/2015
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Last Update Date | 09/19/2015
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Provider Practice Location Address
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Address Line | 4199 MORSE XING
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City | COLUMBUS
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State | OH
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Zip | 43219-6015
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Country | US
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Telephone | 614-269-5517
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Fax |
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Provider Business Mailing Address
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Address Line | 520 WINDING WAY
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City | ZANESVILLE
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State | OH
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Zip | 43701-1578
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Country | US
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Telephone | 614-560-3365
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. SARAH RENEE SCALLEY
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Credential | O.D.
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Telephone | 614-560-3365
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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 | 6069
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License Number State | OH
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