Healthcare Provider Details

I. General information

NPI: 1891250791
Provider Name (Legal Business Name): STEFANIE L ROHLER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2019
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 G AVE
GRUNDY CENTER IA
50638-1651
US

IV. Provider business mailing address

PO BOX 187
GRUNDY CENTER IA
50638-0187
US

V. Phone/Fax

Practice location:
  • Phone: 319-824-6380
  • Fax: 319-824-2306
Mailing address:
  • Phone: 319-824-6380
  • Fax: 319-824-2306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: LUJEAN ANN MULLER
Title or Position: BILLING SPECIALIST
Credential:
Phone: 319-824-6380