Organization
VIRGINIA EYECARE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA JOY UMLANDT OD (OWNER/OPTOMETRIST)
(276) 935-2292
Entity
Organization
Contact information
Practice address
1193 PLAZA DR, GRUNDY, VA 24614-6780
(276) 935-4558
(276) 935-2993
Mailing address
1193 PLAZA DR, GRUNDY, VA 24614-6780
(276) 935-2292
(276) 935-2993
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0601002211
VA
152W00000X
Optometrist
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009237348
—
VA
01
—
143512
ANTHEM
VA
05
—
9200061001
—
WV
Enumeration date
07/28/2006
Last updated
01/15/2023
Update your record
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