Organization
THE RIVIISION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BYRON BONNER OD (OWNER)
(405) 990-0643
Entity
Organization
Contact information
Practice address
8811 S SANTA FE AVE, OKLAHOMA CITY, OK 73139-8410
(405) 990-0643
(405) 561-6803
Mailing address
8811 S SANTA FE AVE, OKLAHOMA CITY, OK 73139-8410
(405) 990-0643
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
—
Other
Enumeration date
07/24/2019
Last updated
02/18/2021
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