Provider Demographics
NPI:1902041346
Name:VISION HEALTH CENTER O.D. P.L.L.C.
Entity Type:Organization
Organization Name:VISION HEALTH CENTER O.D. P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:III
Authorized Official - Credentials:OD
Authorized Official - Phone:540-786-2786
Mailing Address - Street 1:705 KILARNEY DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6509
Mailing Address - Country:US
Mailing Address - Phone:540-786-2786
Mailing Address - Fax:540-785-2763
Practice Address - Street 1:3500 PLANK RD
Practice Address - Street 2:SUITE I
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6887
Practice Address - Country:US
Practice Address - Phone:540-786-2786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001266152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty