| Grace Vision, Llc | |
|
2314 Taylor Park Dr Reynoldsburg OH 43068-8052 | |
| (614) 863-0071 | |
| (614) 856-0534 |
| Full Name | Grace Vision, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2314 Taylor Park Dr, Reynoldsburg, Ohio |
| Authorized Official Name and Position | Dawn Lynette Hartman (OWNER) |
| Authorized Official Contact | 6149468205 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Vision, Llc 6007 Woodbrook Ct Lewis Center OH 43035-9240 Ph: (614) 946-8205 | Grace Vision, Llc 2314 Taylor Park Dr Reynoldsburg OH 43068-8052 Ph: (614) 863-0071 |
| NPI Number | 1225461544 |
|---|---|
| Provider Enumeration Date | 08/11/2013 |
| Last Update Date | 08/11/2013 |
| Medicare PECOS PAC ID | 1658754783 |
|---|---|
| Medicare Enrollment ID | O20220822003459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225461544 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 5016 (Ohio) | Primary |
| Provider Name | Gil Guedes |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1093164147 PECOS PAC ID: 0648568576 Enrollment ID: I20161202000511 |
| Provider Name | Evan Andrews |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861912073 PECOS PAC ID: 8325317472 Enrollment ID: I20190820003748 |
| Provider Name | Jackson David Carey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790350866 PECOS PAC ID: 1951703149 Enrollment ID: I20210709002898 |
| Provider Name | Ellen Larsen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992444772 PECOS PAC ID: 0840670584 Enrollment ID: I20220712000839 |
| Provider Name | Brittany Ann Morettin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1497194849 PECOS PAC ID: 5597124503 Enrollment ID: I20230710001305 |
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