Provider Demographics
NPI:1043468986
Name:L & J VISION CENTER, INC.
Entity Type:Organization
Organization Name:L & J VISION CENTER, INC.
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:ABOC
Authorized Official - Phone:757-480-1134
Mailing Address - Street 1:128 E LITTLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-2503
Mailing Address - Country:US
Mailing Address - Phone:757-480-1134
Mailing Address - Fax:757-480-8655
Practice Address - Street 1:2201 UPTON DRIVE
Practice Address - Street 2:SUITE 902
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454
Practice Address - Country:US
Practice Address - Phone:757-430-2860
Practice Address - Fax:757-430-2862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101003292332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier