Organization Name: | VISION PRO OPTICAL |
NPI Number: | 1306117080 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMIE LOU HOPP (VP OPERATIONS) |
Mailing Address: | 109 Court Ave S Sandstone |
State: | MN US |
Postal Code: | 550725120 |
Phone Number: | 3202452637 |
Fax Number: | 3202450417 |
NPI Enumeration Date: | 01/26/2012 |
NPI Last Update Date: | 01/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |