Organization
PROFESSIONAL VISION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY C FOGT OD (OWNER)
(419) 782-4831
Entity
Organization
Contact information
Practice address
101 CLINTON ST STE 1000, DEFIANCE, OH 43512-2165
(419) 782-4831
Mailing address
101 CLINTON ST STE 1000, DEFIANCE, OH 43512-2165
(419) 782-4831
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
05/02/2007
Last updated
08/22/2020
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