Healthcare Provider Details

I. General information

NPI: 1437848280
Provider Name (Legal Business Name): ARUBA VISION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2023
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 12TH ST
HARLAN IA
51537-2002
US

IV. Provider business mailing address

PO BOX 460
JEFFERSON IA
50129-0460
US

V. Phone/Fax

Practice location:
  • Phone: 712-755-3893
  • Fax: 712-755-7580
Mailing address:
  • Phone: 515-386-3626
  • Fax: 515-386-8921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: TERRY L BROWN
Title or Position: PRESIDENT
Credential: OD
Phone: 515-386-3626