Healthcare Provider Details

I. General information

NPI: 1043322688
Provider Name (Legal Business Name): VISION HEALTH CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 11/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 STATE ST
BELLEVUE IA
52031-1307
US

IV. Provider business mailing address

113 STATE ST
BELLEVUE IA
52031-1307
US

V. Phone/Fax

Practice location:
  • Phone: 563-872-5975
  • Fax: 563-872-3248
Mailing address:
  • Phone: 563-872-5975
  • Fax: 563-872-3248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1784
License Number StateIA

VIII. Authorized Official

Name: STEVEN D. SLOAN
Title or Position: OWNER
Credential: OD
Phone: 563-872-5975