Provider Demographics
NPI:1083420418
Name:VISION DEVELOPMENT CENTER BY VC LLC
Entity type:Organization
Organization Name:VISION DEVELOPMENT CENTER BY VC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:GALBRAITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:417-582-2020
Mailing Address - Street 1:6003 N 21ST ST
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-7634
Mailing Address - Country:US
Mailing Address - Phone:417-582-2020
Mailing Address - Fax:417-725-0502
Practice Address - Street 1:6003 N 21ST ST
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-7634
Practice Address - Country:US
Practice Address - Phone:417-582-2020
Practice Address - Fax:417-725-0502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty