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General NPI Number Information
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NPI Number | 1952047284
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Entity Type | Organization
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Legal Business Name | FRONTIER VISION LLC
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 400 UNIVERSITY DR STE 100
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City | PRESTONSBURG
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State | KY
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Zip | 41653-1080
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Country | US
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Telephone | 606-889-6522
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Fax | 606-889-6453
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Provider Business Mailing Address
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Address Line | PO BOX 697
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City | PRESTONSBURG
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State | KY
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Zip | 41653-0697
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Country | US
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Telephone | 606-889-6522
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Fax | 606-889-6453
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Authorized Official
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Title or Position | OWNER
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Name | ANTOIN HANA
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Credential | MD
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Telephone | 606-889-6522
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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