Provider Demographics
NPI:1487788576
Name:J2VISION SERVICES S.C.
Entity type:Organization
Organization Name:J2VISION SERVICES S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:262-646-9600
Mailing Address - Street 1:2802 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:DELAFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53018-2127
Mailing Address - Country:US
Mailing Address - Phone:262-646-9600
Mailing Address - Fax:262-646-9603
Practice Address - Street 1:2802 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:DELAFIELD
Practice Address - State:WI
Practice Address - Zip Code:53018-2127
Practice Address - Country:US
Practice Address - Phone:262-646-9600
Practice Address - Fax:262-646-9603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty