Lumen Vision PC

NPI #1447879663 in Fargo, North Dakota

Provider Information

NPI Number: 1447879663
Entity Type: Organization
Organization Name: Lumen Vision PC
Primary Specialty: Optometrist
Enumeration Date: Apr 9, 2020
Last Updated: Jun 2, 2021

Practice Location

Address: 5120 PROSPERITY WAY S STE 114
City: Fargo
State: North Dakota
ZIP Code: 58104-7568
Phone: (701) 404-9096

Authorized Official

Name: RYAN THOMAS CAPOUCH, OD
Title: FOUNDER/CEO
Phone: (701) 404-9096

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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