Provider Demographics
NPI:1437928033
Name:ANDERSON VISION LLC
Entity Type:Organization
Organization Name:ANDERSON VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:864-680-3037
Mailing Address - Street 1:120 BELLEMERE PL
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-6903
Mailing Address - Country:US
Mailing Address - Phone:864-225-0474
Mailing Address - Fax:864-225-0547
Practice Address - Street 1:3812 LIBERTY HWY STE 1
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1344
Practice Address - Country:US
Practice Address - Phone:864-225-0474
Practice Address - Fax:864-225-0547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-22
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty