Provider Demographics
NPI:1508100348
Name:VISION CARE & THERAPY CENTER, INC
Entity Type:Organization
Organization Name:VISION CARE & THERAPY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:IYER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:770-616-1991
Mailing Address - Street 1:8343 ROSWELL RD
Mailing Address - Street 2:141
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12030 ETRIS RD
Practice Address - Street 2:B-100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-1410
Practice Address - Country:US
Practice Address - Phone:675-256-3990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-17
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT2678152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty