Organization
INNOVATIVE VISION LLC
Active
Organization
INNOVATIVE VISION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN CORCORAN OD (OWNER)
(513) 793-8486
Entity
Organization
Contact information
Practice address
9711 MONTGOMERY RD, MONTGOMERY, OH 45242-7207
(513) 793-8486
(513) 793-2023
Mailing address
9711 MONTGOMERY RD, MONTGOMERY, OH 45242-7207
(513) 793-8486
(513) 793-2023
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5396
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2225729
—
OH
Enumeration date
11/13/2007
Last updated
06/05/2024
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