Provider Demographics
NPI:1205401882
Name:NEURO-VISION THERAPY CENTER LLC
Entity Type:Organization
Organization Name:NEURO-VISION THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOERR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:240-669-6930
Mailing Address - Street 1:3204 TOWER OAKS BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4382
Mailing Address - Country:US
Mailing Address - Phone:240-669-6930
Mailing Address - Fax:
Practice Address - Street 1:3204 TOWER OAKS BLVD STE 450
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4382
Practice Address - Country:US
Practice Address - Phone:240-669-6930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty