Organization
PEAK VISUAL PERFORMANCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJENDER MACHA OD (PRESIDENT/OWNER)
(765) 649-1200
Entity
Organization
Contact information
Practice address
1607 S SCATTERFIELD RD, STE B, ANDERSON, IN 46016-5788
(765) 649-1200
(765) 649-4040
Mailing address
1537 S SCATTERFIELD RD, STE B, ANDERSON, IN 46016-5766
(765) 649-1200
(765) 649-4040
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002944A
IN
152WS0006X
Sports Vision Optometrist
18002944A
IN
152WV0400X
Vision Therapy Optometrist
18002944A
IN
Other
Enumeration date
01/16/2014
Last updated
01/22/2014
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