Provider Demographics
NPI:1902815053
Name:VISIONMAKERS OF PA
Entity Type:Organization
Organization Name:VISIONMAKERS OF PA
Other - Org Name:VISUALEYES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:STAHL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-258-1515
Mailing Address - Street 1:1934 PARK MANOR BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-4809
Mailing Address - Country:US
Mailing Address - Phone:412-788-4664
Mailing Address - Fax:412-788-6003
Practice Address - Street 1:1934 PARK MANOR BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4809
Practice Address - Country:US
Practice Address - Phone:412-788-4664
Practice Address - Fax:412-788-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty