# LIFETIME VISION CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073886412
- **Authorized official:** DR. DERRI JO SANDBERG OD (OPTOMETRIST)
- **Authorized official phone:** (541) 382-3242

## Contact information

- **Practice address:** 901 NW CARLON AVE, SUITE 2, BEND, OR 97703-2636
- **Practice address phone:** (541) 382-3242
- **Practice address fax:** (541) 317-3579
- **Mailing address:** 901 NW CARLON AVE, SUITE 2, BEND, OR 97703-2636
- **Mailing address phone:** (541) 382-3242
- **Mailing address fax:** (541) 317-3579

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/15/2012
- **Last updated:** 07/15/2015