Organization
VISION SOURCE MEADVILLE LLC
Active
Parent organization
VISION SOURCE MEADVILLE LLC
Other names
Vision Source Titusville, Oil City Eye Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
VISION SOURCE MEADVILLE LLC
Authorized official
KIMBERLY J ADSIT (BUSINESS MANAGER)
(814) 333-6606
Entity
Organization
Contact information
Practice address
1073 S MAIN ST, MEADVILLE, PA 16335-3129
(814) 333-6606
Mailing address
1073 S MAIN ST, MEADVILLE, PA 16335-3129
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000417
PA
152W00000X
Optometrist
OEG000659
PA
152W00000X
Optometrist
OEG002385
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031405540001
—
PA
Enumeration date
12/08/2017
Last updated
06/16/2018
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