Healthcare Provider Details

I. General information

NPI: 1962871186
Provider Name (Legal Business Name): KLEIN EYECARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 09/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16959 EVANS PLZ
OMAHA NE
68116-2388
US

IV. Provider business mailing address

18013 DEWEY CIR
ELKHORN NE
68022-5670
US

V. Phone/Fax

Practice location:
  • Phone: 402-289-0063
  • Fax: 402-289-2253
Mailing address:
  • Phone: 308-238-4630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1346
License Number StateNE

VIII. Authorized Official

Name: AMY KLEIN
Title or Position: OWNER
Credential: O.D.
Phone: 308-238-4630