Provider Demographics
NPI:1518092733
Name:ADVANCEMENTS IN VISION, PA
Entity Type:Organization
Organization Name:ADVANCEMENTS IN VISION, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:AK
Authorized Official - Last Name:HADLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD, FAAO, FCOVD
Authorized Official - Phone:763-241-1090
Mailing Address - Street 1:9125 QUADAY AVE NE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-6651
Mailing Address - Country:US
Mailing Address - Phone:763-241-1090
Mailing Address - Fax:
Practice Address - Street 1:9125 QUADAY AVE NE
Practice Address - Street 2:SUITE 104
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6651
Practice Address - Country:US
Practice Address - Phone:763-241-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty