Provider Demographics
NPI:1205974334
Name:VISION THERAPY CENTER OF CHARLOTTE, LLC
Entity type:Organization
Organization Name:VISION THERAPY CENTER OF CHARLOTTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:HALEO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:803-802-7171
Mailing Address - Street 1:458 CRANBORNE CHASE
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7922
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3686 CENTER CIRCLE
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-9733
Practice Address - Country:US
Practice Address - Phone:803-802-7171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1323152WP0200X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
Not Answered152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty