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Organization

PROSPECT VISION CARE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. VIRGINIA CHETVERIKOV O.D. (OWNER)
(740) 494-2999
Entity
Organization

Contact information

Practice address
100 E WATER ST, PROSPECT, OH 43342-0034
(740) 494-2999
(740) 494-2999
Mailing address
100 E WATER ST, PO BOX 34, PROSPECT, OH 43342-0034
(740) 494-2999
(740) 494-2999

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4919
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2067963
OH
Enumeration date
05/27/2008
Last updated
07/27/2009
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