| Lake Avenue Eyecare, Llc | |
|
829 Lake Ave, Gothenburg, NE 69138-1943 | |
| (308) 537-3390 | |
| (308) 537-3391 |
| Full Name | Lake Avenue Eyecare, Llc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 829 Lake Ave, Gothenburg, Nebraska |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811183783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 1166 (Nebraska) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Avenue Eyecare, Llc 829 Lake Ave, Gothenburg, NE 69138-1943 Ph: (308) 537-3390 | Lake Avenue Eyecare, Llc 829 Lake Ave, Gothenburg, NE 69138-1943 Ph: (308) 537-3390 |
Gothenburg Eyecare & Optical Optometrist Medicare: Medicare Enrolled Practice Location: 902 Avenue D, Ste 102 B, Gothenburg, NE 69138 Phone: 308-537-2020 Fax: 308-537-2280 | |
Lake Avenue Eyecare Llc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 829 Lake Ave, Gothenburg, NE 69138 Phone: 308-537-3390 Fax: 308-537-3391 | |
Kimberly A Johnson, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 902 Avenue D Ste 102b, Gothenburg, NE 69138 Phone: 308-537-2020 Fax: 308-537-2280 |