Provider Demographics
NPI:1912544214
Name:WESLEY J. SANDS VISION CENTER
Entity Type:Organization
Organization Name:WESLEY J. SANDS VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMERTIST
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:931-762-1364
Mailing Address - Street 1:530 HIGHWAY 64 E STE 5
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-3050
Mailing Address - Country:US
Mailing Address - Phone:931-722-5009
Mailing Address - Fax:
Practice Address - Street 1:530 HIGHWAY 64 E STE 5
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-3050
Practice Address - Country:US
Practice Address - Phone:931-722-5009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-05
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty