Provider Demographics
NPI:1669660320
Name:VISION CLINICS LTD
Entity Type:Organization
Organization Name:VISION CLINICS LTD
Other - Org Name:BRUNSWICK VISION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DWAYNE
Authorized Official - Last Name:KAMMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:330-273-1010
Mailing Address - Street 1:946 PEARL RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-2562
Mailing Address - Country:US
Mailing Address - Phone:330-273-1010
Mailing Address - Fax:330-225-8115
Practice Address - Street 1:946 PEARL RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-2562
Practice Address - Country:US
Practice Address - Phone:330-273-1010
Practice Address - Fax:330-225-8115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3247152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1158740002OtherDURABLE MEDICAL EQUIPMENT
OH1158740002OtherDURABLE MEDICAL EQUIPMENT