Healthcare Provider Details

I. General information

NPI: 1528020773
Provider Name (Legal Business Name): VISION CARE ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 ONTARIO ST
STORM LAKE IA
50588-1845
US

IV. Provider business mailing address

PO BOX 1407
STORM LAKE IA
50588-1407
US

V. Phone/Fax

Practice location:
  • Phone: 712-732-3233
  • Fax: 712-732-1866
Mailing address:
  • Phone: 712-732-3233
  • Fax: 712-732-1866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DONOVAN L CROUCH
Title or Position: OPTOMOTRIST
Credential: O.D.
Phone: 712-732-3233