Healthcare Provider Details

I. General information

NPI: 1568427631
Provider Name (Legal Business Name): KARMA BIRGITTA SLOOP O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: KARMA BIRGITTA PETERSON O.D.

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HIGHWAY 1 W
IOWA CITY IA
52246-4227
US

IV. Provider business mailing address

3168 62ND STREET TRL
SHELLSBURG IA
52332-9560
US

V. Phone/Fax

Practice location:
  • Phone: 319-338-4151
  • Fax:
Mailing address:
  • Phone: 319-436-7927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2133
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: