Provider Demographics
NPI:1457774119
Name:VISION CRAFTERS
Entity Type:Organization
Organization Name:VISION CRAFTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVETISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:818-995-7989
Mailing Address - Street 1:13739 RIVERSIDE DR STE A
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2417
Mailing Address - Country:US
Mailing Address - Phone:818-995-7989
Mailing Address - Fax:818-995-7975
Practice Address - Street 1:13739 RIVERSIDE DR STE A
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2417
Practice Address - Country:US
Practice Address - Phone:818-995-7989
Practice Address - Fax:818-995-7975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier