# VISION THERAPY CENTER LLC

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

## Provider details

- **NPI number:** 1356991624
- **Authorized official:** SHANE ALEXANDER CLARK OD (CEO)
- **Authorized official phone:** (605) 342-0258

## Contact information

- **Practice address:** 5734 SHERIDAN LAKE RD STE 202, RAPID CITY, SD 57702-8814
- **Practice address phone:** (605) 342-0258
- **Practice address fax:** (605) 342-0209
- **Mailing address:** 5734 SHERIDAN LAKE RD STE 202, RAPID CITY, SD 57702-8814
- **Mailing address phone:** (605) 342-0258
- **Mailing address fax:** (605) 342-0209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152WV0400X | Vision Therapy Optometrist | — | NULL | Yes |
| 152WV0400X | Vision Therapy Optometrist | — | — | Yes |

## Other

- **Enumeration date:** 09/18/2019
- **Last updated:** 09/19/2023