Provider Demographics
NPI:1639581523
Name:VISIONLOOK INC.
Entity Type:Organization
Organization Name:VISIONLOOK INC.
Other - Org Name:VISIONLOOK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIS
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:GRAJALES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:787-629-2462
Mailing Address - Street 1:PO BOX 3044
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-3044
Mailing Address - Country:US
Mailing Address - Phone:787-629-2462
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 459 KM 2.5
Practice Address - Street 2:BO CAMASEYES
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00605-3044
Practice Address - Country:US
Practice Address - Phone:787-629-2462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR716261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service