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1992315196
DEREK LUKE MADDOX
GRAND ISLAND, NE
NPI
1992315196
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: NE 1516)
Enumeration Date
2020-08-03
Last Update Date
2023-12-14
Business Address
DEREK LUKE MADDOX OD
3540 PRAIRIEVIEW ST
GRAND ISLAND, NE 68803
Phone number: 308-384-6922
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Mailing Address
DEREK LUKE MADDOX OD
3540 PRAIRIEVIEW ST
GRAND ISLAND, NE 68803
Phone number: 308-384-6922
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