Provider Demographics
NPI:1467018705
Name:VISION PRO II, INC
Entity type:Organization
Organization Name:VISION PRO II, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEVERIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-621-2020
Mailing Address - Street 1:1806 BELKNAP ST
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-2595
Mailing Address - Country:US
Mailing Address - Phone:715-392-6222
Mailing Address - Fax:
Practice Address - Street 1:38814 3RD AVE
Practice Address - Street 2:
Practice Address - City:NORTH BRANCH
Practice Address - State:MN
Practice Address - Zip Code:55056-5962
Practice Address - Country:US
Practice Address - Phone:651-674-9974
Practice Address - Fax:651-674-0347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-13
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty