Provider Demographics
NPI:1235177940
Name:VISION EXPETS INC.
Entity Type:Organization
Organization Name:VISION EXPETS INC.
Other - Org Name:KNIGHTON VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-882-1876
Mailing Address - Street 1:404 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-6321
Mailing Address - Country:US
Mailing Address - Phone:801-621-1475
Mailing Address - Fax:801-627-1054
Practice Address - Street 1:404 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-6321
Practice Address - Country:US
Practice Address - Phone:801-621-1475
Practice Address - Fax:801-627-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
5480010001Medicare ID - Type Unspecified