Healthcare Provider Details

I. General information

NPI: 1619937133
Provider Name (Legal Business Name): IOWA EYECARE ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 HOME PLZ SUITE 100
WATERLOO IA
50701-4822
US

IV. Provider business mailing address

309 E CHURCH ST
MARSHALLTOWN IA
50158-2919
US

V. Phone/Fax

Practice location:
  • Phone: 319-236-0815
  • Fax: 319-234-0847
Mailing address:
  • Phone: 641-754-6200
  • Fax: 641-754-6215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID MOENCH
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 641-754-6200