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SAINT JOSEPH VISION THERAPY LLC NPI 1669937926


NPI Information

NPI: 1669937926
Provider Name: SAINT JOSEPH VISION THERAPY LLC
Classification: Optometrist - 152WV0400X
Entity Type: Organization

Specialization: Vision Therapy

CLIA Number: 23D0377514

Address:
2908 DIVISION ST
SAINT JOSEPH, MI
ZIP 49085
Phone: (269) 983-3309
Get Directions

SAINT JOSEPH VISION THERAPY LLC is a vision therapy optometrist in Saint Joseph, MI. The provider is optometrists who specialize in vision therapy as a treatment process used to improve vision function. It includes a broad range of developmental and rehabilitative treatment programs individually prescribed to remediate specific sensory, motor and/or visual perceptual dysfunctions. SAINT JOSEPH VISION THERAPY LLC NPI is 1669937926. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2908 DIVISION ST
SAINT JOSEPH, MI
ZIP 49085-437
Phone: (269) 983-3309
Fax: (269) 983-0846

The provider's authorized official is Charles Fortenbacher .
The authorized official title is Cfo and has the following contact phone number (269) 449-1513.

The CLIA number assigned to this NPI record is 23D0377514 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/31/2019 and was last updated on 1/31/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152WS0006XOptometristSports VisionNo
2152WV0400XOptometristVision TherapyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
14901002693OTHERMICHIGANOPTOMETRY LICENSE
2900A165280OTHERMICHIGANBLUE CROSS BLUE SHIELD OF MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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