Provider Demographics
NPI:1659027548
Name:VISION HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:VISION HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CORIE
Authorized Official - Middle Name:DEAUN
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:CPOC
Authorized Official - Phone:801-391-5512
Mailing Address - Street 1:7555 S CENTER VIEW CT STE 101
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84084-1970
Mailing Address - Country:US
Mailing Address - Phone:801-566-5683
Mailing Address - Fax:801-255-8371
Practice Address - Street 1:10372 S REDWOOD RD
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-9339
Practice Address - Country:US
Practice Address - Phone:801-253-1374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VISION HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-01
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty