Provider Demographics
NPI:1659162550
Name:DISCOVERY VISION LLC
Entity type:Organization
Organization Name:DISCOVERY VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HADNOT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:406-390-1677
Mailing Address - Street 1:2829 GREAT NORTHERN LOOP STE 100
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-1752
Mailing Address - Country:US
Mailing Address - Phone:406-542-6382
Mailing Address - Fax:
Practice Address - Street 1:2829 GREAT NORTHERN LOOP STE 100
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1752
Practice Address - Country:US
Practice Address - Phone:406-542-6382
Practice Address - Fax:406-542-4773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty