Healthcare Provider Details

I. General information

NPI: 1760636807
Provider Name (Legal Business Name): SEWARD VISION CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2008
Last Update Date: 02/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 S COLUMBIA AVE
SEWARD NE
68434-2206
US

IV. Provider business mailing address

236 S COLUMBIA AVE PO BOX 129
SEWARD NE
68434-2206
US

V. Phone/Fax

Practice location:
  • Phone: 402-643-2944
  • Fax:
Mailing address:
  • Phone: 402-643-2944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1050
License Number StateNE

VIII. Authorized Official

Name: DR. CRAIG ALAN SLEPICKA
Title or Position: PRESIDENT
Credential: OD
Phone: 402-643-2944