Vision Source of Mt Olive LLC

NPI #1063766202 in Budd Lake, New Jersey

Provider Information

NPI Number: 1063766202
Entity Type: Organization
Organization Name: Vision Source of Mt Olive LLC
Primary Specialty: Optometrist
Enumeration Date: Nov 8, 2012
Last Updated: Nov 15, 2012

Practice Location

Address: 135 ROUTE 46 EAST
Address 2: UNIT E
City: Budd Lake
State: New Jersey
ZIP Code: 07828
Phone: (862) 258-3200

Authorized Official

Name: DR. MICHAEL J SIEGEL, OD
Title: PRESIDENT
Phone: (862) 258-3200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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