Organization
INNOVATIVE VISION THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TABITHA JOHNSON (OWNER)
(864) 540-8404
Entity
Organization
Contact information
Practice address
3215 MARTIN LUTHER KING JR BLVD STE O, ANDERSON, SC 29625-1715
(864) 540-8404
Mailing address
3215 MARTIN LUTHER KING JR BLVD STE O, ANDERSON, SC 29625-1715
(864) 540-8404
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
Primary
—
SC
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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