Provider Demographics
NPI:1619367836
Name:VISION SITE, LLC
Entity Type:Organization
Organization Name:VISION SITE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPPELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:262-644-0707
Mailing Address - Street 1:425A E WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:SLINGER
Mailing Address - State:WI
Mailing Address - Zip Code:53086-9440
Mailing Address - Country:US
Mailing Address - Phone:262-644-0707
Mailing Address - Fax:
Practice Address - Street 1:425A E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SLINGER
Practice Address - State:WI
Practice Address - Zip Code:53086-9440
Practice Address - Country:US
Practice Address - Phone:262-644-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3134-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty