Provider Demographics
NPI:1891171666
Name:ZANESVILLE VISION CARE LLC
Entity type:Organization
Organization Name:ZANESVILLE VISION CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-453-1611
Mailing Address - Street 1:2315 MAPLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-2028
Mailing Address - Country:US
Mailing Address - Phone:740-453-1611
Mailing Address - Fax:740-450-7680
Practice Address - Street 1:2315 MAPLE AVENUE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-2028
Practice Address - Country:US
Practice Address - Phone:740-453-1611
Practice Address - Fax:740-450-7680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty