Organization
DAVID VISE OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID RICHARD VISE O.D. (OPTOMETRIST)
(505) 473-5100
Entity
Organization
Contact information
Practice address
3530 ZAFARANO DR, SUITE C1, SANTA FE, NM 87507-2617
(505) 473-5100
(505) 473-5104
Mailing address
3530 ZAFARANO DR, SUITE C1, SANTA FE, NM 87507-2617
(505) 473-5100
(505) 473-5104
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
411
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
J9416
—
NM
Enumeration date
05/01/2013
Last updated
08/13/2013
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