Provider Demographics
NPI:1346537701
Name:VISION LEARNING CENTER OF AVON
Entity Type:Organization
Organization Name:VISION LEARNING CENTER OF AVON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:E
Authorized Official - Last Name:JUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD, MS, FCOVD
Authorized Official - Phone:317-745-7000
Mailing Address - Street 1:5055 E. US HIGHWAY 36
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AVON
Mailing Address - State:IN
Mailing Address - Zip Code:46123-0533
Mailing Address - Country:US
Mailing Address - Phone:317-745-7000
Mailing Address - Fax:317-745-2294
Practice Address - Street 1:5055 E. US HIGHWAY 36
Practice Address - Street 2:SUITE 200
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-0533
Practice Address - Country:US
Practice Address - Phone:317-745-7000
Practice Address - Fax:317-745-2294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003213152W00000X, 152WP0200X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty