Provider Demographics
NPI:1083037147
Name:JL VISION, LLC
Entity Type:Organization
Organization Name:JL VISION, LLC
Other - Org Name:PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JANETTE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:402-968-0886
Mailing Address - Street 1:396 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOXFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01921-1418
Mailing Address - Country:US
Mailing Address - Phone:978-352-8623
Mailing Address - Fax:
Practice Address - Street 1:90 PLEASANT VALLEY ST
Practice Address - Street 2:SUITE 250
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-7212
Practice Address - Country:US
Practice Address - Phone:978-683-2020
Practice Address - Fax:978-683-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4736332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier