| NPI | 1811088586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN K SWAN Administrator 641-682-8571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2020-08-22 |