Organization
PROVISION EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM MELTON (PRESIDENT)
(804) 756-2020
Entity
Organization
Contact information
Practice address
10212 STAPLES MILL RD, GLEN ALLEN, VA 23060-3064
(804) 756-2020
(804) 447-6885
Mailing address
10212 STAPLES MILL RD, GLEN ALLEN, VA 23060-3064
(804) 756-2020
(804) 447-6885
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001394
VA
152WC0802X
Corneal and Contact Management Optometrist
0618001394
VA
Other
Enumeration date
04/10/2017
Last updated
09/30/2025
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