Provider Demographics
NPI:1477218188
Name:GALLATIN VALLEY VISION, LLC
Entity Type:Organization
Organization Name:GALLATIN VALLEY VISION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:N
Authorized Official - Last Name:LEMONS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-285-6901
Mailing Address - Street 1:PO BOX 1008
Mailing Address - Street 2:
Mailing Address - City:THREE FORKS
Mailing Address - State:MT
Mailing Address - Zip Code:59752-1008
Mailing Address - Country:US
Mailing Address - Phone:406-285-6901
Mailing Address - Fax:
Practice Address - Street 1:9 E BIRCH ST
Practice Address - Street 2:
Practice Address - City:THREE FORKS
Practice Address - State:MT
Practice Address - Zip Code:59752
Practice Address - Country:US
Practice Address - Phone:406-285-6901
Practice Address - Fax:406-285-6511
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GALLATIN VALLEY VISION, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty