Organization
VISION ASSOCIATES OF WESTERN PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON WAYNE HULL O.D. (PRESIDENT/CEO)
(814) 864-4858
Entity
Organization
Contact information
Practice address
200 MILLCREEK PLZ, ERIE, PA 16565-1102
(814) 864-4858
(814) 864-0398
Mailing address
200 MILLCREEK PLZ, ERIE, PA 16565-1102
(814) 864-4858
(814) 864-0398
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VI1521630
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/22/2007
Last updated
07/22/2007
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