MEDICARE: QUALITY VISION CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician		OK

General Provider Information

NPI Number	:	1063561108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY VISION CENTER, INC.

Provider Business Mailing Address
First Line	:	2350 SE WASHINGTON BLVD STE 228
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7211
Country	:	US
Telephone Number	:	918-333-2929
Fax Number	:	918-333-4651

Provider Business Practice Location Address
First Line	:	2350 SE WASHINGTON BLVD STE 228
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7211
Country	:	US
Telephone Number	:	918-333-2929
Fax Number	:	918-333-4651

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BARBARA A MOBERLY
Credential	:
Telephone Number	:	918-333-2929

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	02/04/2008

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