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General NPI Number Information
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NPI Number | 1043282148
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Entity Type | Organization
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Legal Business Name | FUERSTE EYE CLINIC
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 2140 JFK RD STE F
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City | DUBUQUE
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State | IA
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Zip | 52002-3883
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Country | US
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Telephone | 563-582-7167
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Fax | 563-582-5772
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Provider Business Mailing Address
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Address Line | 2140 JFK RD STE F
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City | DUBUQUE
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State | IA
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Zip | 52002-3883
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Country | US
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Telephone | 563-582-7167
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Fax | 563-582-5772
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | DR. GRETCHEN FUERSTE
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Credential | MD
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Telephone | 563-582-7167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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