Healthcare Provider Details

I. General information

NPI: 1437154705
Provider Name (Legal Business Name): GERING VISION CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 08/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1605 10TH ST SUITE B
GERING NE
69341-2409
US

IV. Provider business mailing address

1605 10TH ST SUITE B
GERING NE
69341-2409
US

V. Phone/Fax

Practice location:
  • Phone: 308-436-3176
  • Fax: 308-436-9105
Mailing address:
  • Phone: 308-436-3176
  • Fax: 308-436-9105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number789
License Number StateNE

VIII. Authorized Official

Name: STEVEN LEE WASSERBURGER
Title or Position: OWNER/PRESIDENT
Credential: O.D.
Phone: 308-436-3176