Organization
VISTA OPTICAL
Active
Parent organization
NATIONAL VISION, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
NATIONAL VISION, INC.
Authorized official
LEAHANN RENE VAUGHN (DIRECTOR)
(470) 448-2782
Entity
Organization
Contact information
Practice address
102 W OCTAGON ST, BLDG 77B, CANNON AFB, NM 88103-5207
(575) 904-1001
(575) 784-9722
Mailing address
2435 COMMERCE AVE, BLDG 2200, DULUTH, GA 30096-4980
(770) 822-3600
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
156FX1800X
Optician
—
—
Other
Enumeration date
07/18/2016
Last updated
09/17/2021
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