Organization
PEDIATRIC VISION DEVELOPMENT CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEGAN PETTY OD (PRESIDENT)
(479) 795-1411
Entity
Organization
Contact information
Practice address
101 DAWN DR, CENTERTON, AR 72719-9314
(479) 795-1411
(479) 795-1412
Mailing address
101 DAWN DR, CENTERTON, AR 72719-9314
(479) 795-1411
(479) 795-1412
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
2568
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2568
STATE LICENSE
AR
Enumeration date
12/29/2006
Last updated
12/18/2013
Update your record
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