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General NPI Number Information
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NPI Number | 1033242375
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Entity Type | Organization
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Legal Business Name | VALENTINE VISION CENTER INC
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Dates
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Enumeration Date | 03/14/2007
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Last Update Date | 12/09/2009
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Provider Practice Location Address
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Address Line | 318 N MAIN ST
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City | VALENTINE
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State | NE
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Zip | 69201-1842
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Country | US
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Telephone | 402-376-2020
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Fax | 402-376-1652
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Provider Business Mailing Address
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Address Line | 318 N MAIN ST
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City | VALENTINE
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State | NE
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Zip | 69201-1842
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CALVIN K BANCROFT
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Credential | O.D.
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Telephone | 402-376-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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