MEDICARE: DR. TRISHA BARNES VANCE OD

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	152W00000X	Optometrist	5578	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	VA4169691	OTHER		PIN

General Provider Information

NPI Number	:	1922025402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRISHA BARNES VANCE OD

Provider Business Mailing Address
First Line	:	8614 WESTWOOD CENTER DR FL 9
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-2442
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:

Provider Business Practice Location Address
First Line	:	602 SOUTH ST
Second Line	:	SUITE B-14
City	:	CHARDON
State	:	OH
Zip	:	44024-1499
Country	:	US
Telephone Number	:	440-285-5007
Fax Number	:	440-285-4313

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/15/2024

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