Provider Demographics
NPI:1740386259
Name:TORRINGTON VISION CLINIC, P.C.
Entity Type:Organization
Organization Name:TORRINGTON VISION CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:307-532-4114
Mailing Address - Street 1:1418 E M ST
Mailing Address - Street 2:
Mailing Address - City:TORRINGTON
Mailing Address - State:WY
Mailing Address - Zip Code:82240-3533
Mailing Address - Country:US
Mailing Address - Phone:307-532-4114
Mailing Address - Fax:307-532-7658
Practice Address - Street 1:1418 E M ST
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240-3533
Practice Address - Country:US
Practice Address - Phone:307-532-4114
Practice Address - Fax:307-532-7658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY106824500Medicaid
WY0715360001Medicare NSC
WYW4590640Medicare PIN