| NPI | 1740279470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE RAHE BOTTELSON Insurance Manager 515-274-6452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 1684) |
| Enumeration Date | 2005-10-15 |
| Last Update Date | 2009-07-13 |