Provider Demographics
NPI:1841474186
Name:VISION SOURCE OF HENDERSONVILLE
Entity type:Organization
Organization Name:VISION SOURCE OF HENDERSONVILLE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFFY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-824-4246
Mailing Address - Street 1:100 COUNTRY CLUB DRIVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-4025
Mailing Address - Country:US
Mailing Address - Phone:615-824-4246
Mailing Address - Fax:800-216-3102
Practice Address - Street 1:100 COUNTRY CLUB DRIVE
Practice Address - Street 2:SUITE 106
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-4025
Practice Address - Country:US
Practice Address - Phone:615-824-4246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000002721152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty