Provider Demographics
NPI:1376795922
Name:LOW VISION THERAPY, LLC
Entity Type:Organization
Organization Name:LOW VISION THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:703-505-5771
Mailing Address - Street 1:1504 KINGSTREAM CIRCLE
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2700
Mailing Address - Country:US
Mailing Address - Phone:703-505-5771
Mailing Address - Fax:703-437-0168
Practice Address - Street 1:1504 KINGSTREAM CIRCLE
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-2700
Practice Address - Country:US
Practice Address - Phone:703-505-5771
Practice Address - Fax:703-437-0168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty