Provider Demographics
NPI:1235841917
Name:VISIONARY OPTOMETRICS, LLC
Entity Type:Organization
Organization Name:VISIONARY OPTOMETRICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMRON
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:573-714-2075
Mailing Address - Street 1:1413 RIPLEY ROUTE A
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:MO
Mailing Address - Zip Code:63935-7815
Mailing Address - Country:US
Mailing Address - Phone:573-714-2075
Mailing Address - Fax:
Practice Address - Street 1:1122 N DOUGLASS ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MO
Practice Address - Zip Code:63863-1342
Practice Address - Country:US
Practice Address - Phone:573-276-3239
Practice Address - Fax:573-276-2511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty