Organization
ENVISION PROFESSIONAL GROUP, PLLC
Active
Parent organization
SMYTH COUNTY EYE ASSOCIATES, INC.
Other names
Envision Eye Care, Smyth County Eye Associates, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SMYTH COUNTY EYE ASSOCIATES, INC.
Authorized official
TINA B BLEVINS (ADMINISTRATOR)
(276) 783-5157
Entity
Organization
Contact information
Practice address
1020 TERRACE DR, SUITE 100, MARION, VA 24354
(276) 783-5157
(276) 783-5159
Mailing address
1020 TERRACE DR, SUITE 100, MARION, VA 24354-4392
(276) 783-5157
(276) 783-5159
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
0618000072
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009234080
—
VA
05
—
9234080
—
VA
Enumeration date
09/20/2006
Last updated
02/20/2020
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