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Make sure you have the following items ready or accessible. This will help ensure a smooth and efficient process.
1. Practice owner includes ownership and control of a practice and dispensary
Provider Information
If you wish to add more than one additional language, please email providernetworkdevelopment@vsp.com.
Primary Practice Information
Location 1
Location 2
Location 3
Location 4
Location 5
Location 6
Location 7
Location 8
Location 9
Location 10
Owner Attestation
Please review and check the box next to each statement prior to your submission.
*Majority ownership may be solely or with another/other current or applicant VSP Network Doctors.
Warning: It looks like you haven’t confirmed all required items. We recommend completing these steps before submitting your form. Do you still want to continue?