Healthcare Provider Details

I. General information

NPI: 1083777676
Provider Name (Legal Business Name): HOWLIN VISION CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5129 S WESTERN AVE
SIOUX FALLS SD
57108
US

IV. Provider business mailing address

5129 S WESTERN AVE
SIOUX FALLS SD
57108
US

V. Phone/Fax

Practice location:
  • Phone: 605-332-2231
  • Fax: 605-330-9519
Mailing address:
  • Phone: 605-332-2231
  • Fax: 605-330-9519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number445
License Number StateSD

VIII. Authorized Official

Name: LISA M KOLLIS-YOUNG
Title or Position: CEO
Credential: OD
Phone: 605-332-2231