Organization
DELAWARE VALLEY VISION ASSOCIATES GROUP PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM MILLER (BILLING MANAGER)
(610) 491-2127
Entity
Organization
Contact information
Practice address
200 MALL BLVD, KING OF PRUSSIA, PA 19406-2902
(610) 337-1580
Mailing address
200 MALL BLVD, KING OF PRUSSIA, PA 19406-2902
(610) 337-1580
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1745652
BLUE SHIELD
PA
Enumeration date
03/17/2008
Last updated
03/17/2008
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