Provider Demographics
NPI:1386029494
Name:VOSS VISION, LLC
Entity Type:Organization
Organization Name:VOSS VISION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JENNING
Authorized Official - Middle Name:N
Authorized Official - Last Name:VOSS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:307-248-4150
Mailing Address - Street 1:PO BOX 970
Mailing Address - Street 2:
Mailing Address - City:AFTON
Mailing Address - State:WY
Mailing Address - Zip Code:83110-0970
Mailing Address - Country:US
Mailing Address - Phone:307-885-3975
Mailing Address - Fax:
Practice Address - Street 1:50 EAST 4TH AVE.
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:WY
Practice Address - Zip Code:83110
Practice Address - Country:US
Practice Address - Phone:307-885-3975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1811249154OtherVSP