Provider Demographics
NPI:1174067847
Name:COMPLETE VISON CARE CENTER LLC
Entity type:Organization
Organization Name:COMPLETE VISON CARE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:480-443-1150
Mailing Address - Street 1:14100 N NORTHSIGHT BLVD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3628
Mailing Address - Country:US
Mailing Address - Phone:480-443-1150
Mailing Address - Fax:480-443-7393
Practice Address - Street 1:14100 N NORTHSIGHT BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3628
Practice Address - Country:US
Practice Address - Phone:480-443-1150
Practice Address - Fax:480-443-7393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty