Provider Demographics
NPI:1891856282
Name:VISION DEVELOPMENT CENTER LLC
Entity Type:Organization
Organization Name:VISION DEVELOPMENT CENTER LLC
Other - Org Name:BIRMINGHAM VISION THERAPY LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:POMA-NOWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:248-539-4800
Mailing Address - Street 1:4114 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48301
Mailing Address - Country:US
Mailing Address - Phone:248-539-4804
Mailing Address - Fax:248-539-4894
Practice Address - Street 1:4114 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD TWP
Practice Address - State:MI
Practice Address - Zip Code:48301
Practice Address - Country:US
Practice Address - Phone:248-539-4804
Practice Address - Fax:248-539-4894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI90OF301069OtherBCBS MI