Healthcare Provider Details

I. General information

NPI: 1992777221
Provider Name (Legal Business Name): LAURA J SLOWEY OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CORNHUSKER DR
SOUTH SIOUX CITY NE
68776-3924
US

IV. Provider business mailing address

2709 ABBOTT CIR
YANKTON SD
57078-5330
US

V. Phone/Fax

Practice location:
  • Phone: 402-494-8858
  • Fax:
Mailing address:
  • Phone: 605-660-3896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number598
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: