Provider Demographics
NPI:1497901540
Name:INFINITE VISION LLC
Entity Type:Organization
Organization Name:INFINITE VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WONCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:985-789-7624
Mailing Address - Street 1:4050 LONESOME ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448
Mailing Address - Country:US
Mailing Address - Phone:985-789-7624
Mailing Address - Fax:985-777-9090
Practice Address - Street 1:4050 LONESOME ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448
Practice Address - Country:US
Practice Address - Phone:985-789-7624
Practice Address - Fax:985-777-9090
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INFINITE VISION LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-08
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1360-494T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty