Provider Demographics
NPI:1003060633
Name:VISION PRO
Entity Type:Organization
Organization Name:VISION PRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-724-1341
Mailing Address - Street 1:914 HIGHWAY 33 S
Mailing Address - Street 2:
Mailing Address - City:CLOQUET
Mailing Address - State:MN
Mailing Address - Zip Code:55720-2624
Mailing Address - Country:US
Mailing Address - Phone:218-879-5022
Mailing Address - Fax:218-879-5022
Practice Address - Street 1:914 HIGHWAY 33 S
Practice Address - Street 2:
Practice Address - City:CLOQUET
Practice Address - State:MN
Practice Address - Zip Code:55720-2624
Practice Address - Country:US
Practice Address - Phone:218-879-5022
Practice Address - Fax:218-879-5022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty