Organization
VISION SOURCE OF LEWIS COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH YOUNG OD (OWNER)
(615) 373-0080
Entity
Organization
Contact information
Practice address
617 W MAIN ST, HOHENWALD, TN 38462-1355
(615) 373-0080
Mailing address
205 WARD CIR, BRENTWOOD, TN 37027-7552
(615) 373-0080
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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