National Provider Identifier

Exodus Vision, LLC

Exodus Vision, LLC is listed in the NPPES registry with a primary specialty of Optometrist in Rochester, NY and a listed phone number of (585) 254-0022.

NPI 1215205679Rochester, NYOptometrist

Profile Overview

NPI
1215205679
Provider Type
Organization
Primary Specialty
Optometrist
Enumeration Date
December 13, 2011
Last Updated
December 13, 2011

Practice Location

  • 1260 Lyell Ave
  • Rochester, NY 14606-2040

Phone: (585) 254-0022

Mailing Address

  • 2191 Columbia Ave W
  • Battle Creek, MI 49015-2847

Specialties

  • Optometrist (152W00000X)
  • Clinic/Center (261Q00000X)
Full Record
NPI
1215205679
Entity Type
Organization
EIN
<UNAVAIL>
Organization Name
Exodus Vision, LLC
Other Organization Name
<Unavail>
Provider Other Organization Name Type Code
6
Mailing Street Address
2191 Columbia Ave W
Mailing City
Battle Creek
Mailing State
MI
Mailing ZIP Code
49015-2847
Mailing Country
US
Mailing Phone
(269) 968-1600
Mailing Fax
(269) 968-1600
Practice Street Address
1260 Lyell Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14606-2040
Practice Country
US
Practice Phone
(585) 254-0022
Practice Fax
(585) 254-0132
Enumeration Date
December 13, 2011
Last Updated
December 13, 2011
Authorized Official Last Name
Ho
Authorized Official First Name
Patrick
Authorized Official Title
CEO
Authorized Official Phone
(585) 254-0022
Organization Subpart
No
Authorized Official Name Prefix Text
Mr.
Taxonomy Group 2
193400000X Single Specialty Group
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Optometrist (152W00000X), Clinic/Center (261Q00000X)