Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Optician |
156FX1800X | 96[5] | Optician | |
Contact Lens Fitter |
156FC0801X |
| NPI Number | 1487707881 |
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| LBN Legal business name | JACKSON ARD VISION CENTER | ||||||||||||
| Authorized official | MARVIN ARD - (PRESIDENT) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 01/19/2007 | ||||||||||||
| Last updated | 04/07/2008 - About 18 years ago | ||||||||||||
| Identifiers |
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