Organization
NEO VISION PC
Active
Other names
Neo Vision Optical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT CHARLES LOEW OD (PRESIDENT)
(765) 446-2814
Entity
Organization
Contact information
Practice address
2200 ELMWOOD AVENUE, SUITE D11, LAFAYETTE, IN 47904
(765) 446-2814
(765) 447-2870
Mailing address
2200 ELMWOOD AVENUE, SUITE D11, LAFAYETTE, IN 47904
(765) 446-2814
(765) 447-2870
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
68000021A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200878340
—
IN
Enumeration date
03/03/2006
Last updated
10/21/2010
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