Provider Demographics
NPI:1538448592
Name:JOSEPH W. VINCENT O.D. AND JUSTINE E. REDLIN O.D. VISION CARE P.C.
Entity type:Organization
Organization Name:JOSEPH W. VINCENT O.D. AND JUSTINE E. REDLIN O.D. VISION CARE P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:307-679-6832
Mailing Address - Street 1:523 9TH ST S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-2113
Mailing Address - Country:US
Mailing Address - Phone:307-679-6832
Mailing Address - Fax:
Practice Address - Street 1:523 9TH ST S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-2113
Practice Address - Country:US
Practice Address - Phone:307-679-6832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT825152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty