| |
1523-1525 E. San Marnan Dr, Waterloo, IA 50702-4300 | |
(956) 335-6476 | |
(561) 828-8367 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 1523-1525 E. San Marnan Dr, Waterloo, Iowa |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184342933 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
1523-1525 E. San Marnan Dr, Waterloo, IA 50702-4300 Ph: (956) 335-6476 | 1523-1525 E. San Marnan Dr, Waterloo, IA 50702-4300 Ph: (956) 335-6476 |