Provider Demographics
NPI:1851166946
Name:NEW VISION O&P LLC
Entity Type:Organization
Organization Name:NEW VISION O&P LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:970-389-8434
Mailing Address - Street 1:2100 RIVEREDGE PKWY STE 150
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4695
Mailing Address - Country:US
Mailing Address - Phone:404-446-4430
Mailing Address - Fax:404-400-4996
Practice Address - Street 1:2100 RIVEREDGE PKWY STE 150
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4695
Practice Address - Country:US
Practice Address - Phone:404-446-4430
Practice Address - Fax:404-400-4996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier