| Organization Name: | NATIONAL VISION |
| NPI Number: | 1104051390 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEANNINE L BOWER (LICENSED OPTICIAN) |
| Mailing Address: | 16 Old Gick Rd Saratoga Spgs |
| State: | NY US |
| Postal Code: | 128669452 |
| Phone Number: | 5185870258 |
| Fax Number: | 5185833991 |
| NPI Enumeration Date: | 05/18/2009 |
| NPI Last Update Date: | 05/18/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | 008386-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |