Provider Demographics
NPI:1528463981
Name:CENTURY VISION CENTER, CHTD.
Entity type:Organization
Organization Name:CENTURY VISION CENTER, CHTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUTCHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:702-944-2001
Mailing Address - Street 1:8230 W SAHARA AVE
Mailing Address - Street 2:STE 121
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-8959
Mailing Address - Country:US
Mailing Address - Phone:702-877-3937
Mailing Address - Fax:702-877-3935
Practice Address - Street 1:10870 W. CHARLESTON BLVD
Practice Address - Street 2:STE 105
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89135
Practice Address - Country:US
Practice Address - Phone:702-877-3937
Practice Address - Fax:702-877-3935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-28
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty