| NPI | 1306056510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH RICHARD HANSEN Doctor Of Optometry 515-964-1671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 01592) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-03-07 |