Provider Demographics
NPI:1598128696
Name:CENTER FOR VISION THERAPY
Entity Type:Organization
Organization Name:CENTER FOR VISION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUHL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-890-2020
Mailing Address - Street 1:4102 GEORGE WASHINGTON MEM HWY
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:VA
Mailing Address - Zip Code:23692-2885
Mailing Address - Country:US
Mailing Address - Phone:757-890-2020
Mailing Address - Fax:757-890-9125
Practice Address - Street 1:4102 GEORGE WASHINGTON MEM HWY
Practice Address - Street 2:
Practice Address - City:YORKTOWN
Practice Address - State:VA
Practice Address - Zip Code:23692-2885
Practice Address - Country:US
Practice Address - Phone:757-890-2020
Practice Address - Fax:757-890-9125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA06030004442084B0040X, 2084P0301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0301XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBrain Injury MedicineGroup - Multi-Specialty
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Multi-Specialty