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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
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