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General NPI Number Information
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NPI Number | 1992203665
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Entity Type | Organization
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Legal Business Name | HELIOS VISION GROUP, INC.
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 01/29/2018
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Provider Practice Location Address
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Address Line | 3200 ATLANTIC BLVD NE
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City | CANTON
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State | OH
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Zip | 44705-3933
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Country | US
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Telephone | 330-489-9145
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Fax |
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Provider Business Mailing Address
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Address Line | 10139 ROYALTON RD STE D
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City | NORTH ROYALTON
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State | OH
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Zip | 44133-4473
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Country | US
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Telephone | 330-915-3007
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDAR ANDRICH
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Credential | O.D., FCOVD
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Telephone | 440-336-1185
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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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