Provider Demographics
NPI:1407871320
Name:VISION MASTERS CORP
Entity Type:Organization
Organization Name:VISION MASTERS CORP
Other - Org Name:VISION MASTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MIGNOGNA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-266-7700
Mailing Address - Street 1:706 GRAPE STREET
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052
Mailing Address - Country:US
Mailing Address - Phone:610-266-7700
Mailing Address - Fax:610-266-9300
Practice Address - Street 1:706 GRAPE STREET
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052
Practice Address - Country:US
Practice Address - Phone:610-266-7700
Practice Address - Fax:610-266-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE 007828 T152W00000X
PAOE007800T152W00000X
PAOEG001256152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty