Organization
PREMIER VISION GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KELLY JEAN NICHOLS (OPTICIAN/OFFICER MANAGER)
(775) 746-8884
Entity
Organization
Contact information
Practice address
9700 S MCCARRAN BLVD, RENO, NV 89523-9203
(775) 746-8884
(775) 746-5316
Mailing address
9700 S MCCARRAN BLVD, RENO, NV 89523-9203
(775) 746-8884
(775) 746-5316
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD278
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410030899
MEDICARE RAILROAD
NV
Enumeration date
09/12/2008
Last updated
11/12/2008
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