Provider Demographics
NPI:1316191786
Name:VISION PRO
Entity Type:Organization
Organization Name:VISION PRO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-392-6222
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:MOOSE LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55767-0335
Mailing Address - Country:US
Mailing Address - Phone:218-485-8888
Mailing Address - Fax:218-485-8888
Practice Address - Street 1:125 W ARROWHEAD RD
Practice Address - Street 2:
Practice Address - City:MOOSE LAKE
Practice Address - State:MN
Practice Address - Zip Code:55767
Practice Address - Country:UM
Practice Address - Phone:218-485-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty