Provider Demographics
NPI:1558769075
Name:VISION THERAPY ASSOCIATES PC
Entity Type:Organization
Organization Name:VISION THERAPY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LATIMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:405-605-5582
Mailing Address - Street 1:8901 S SANTA FE AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-8413
Mailing Address - Country:US
Mailing Address - Phone:405-605-5582
Mailing Address - Fax:405-237-1279
Practice Address - Street 1:8901 S SANTA FE AVE
Practice Address - Street 2:SUITE K
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-8413
Practice Address - Country:US
Practice Address - Phone:405-605-5582
Practice Address - Fax:405-237-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2307152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty