Basic Information
| Provider Information | |||||||||
| NPI: | 1356454466 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VISION SERVICES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 W EXCHANGE ST | ||||||||
| Address2: | |||||||||
| City: | SPRING LAKE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494562024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6168460620 | ||||||||
| FaxNumber: | 6168446079 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 NORTH AVE | ||||||||
| Address2: | |||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490173417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2699627595 | ||||||||
| FaxNumber: | 2699639202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 10/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | WESTRA | ||||||||
| AuthorizedOfficialFirstName: | JONATHAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 6168460620 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 4901002642 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist |
No ID Information.