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General NPI Number Information
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NPI Number | 1073924155
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Entity Type | Organization
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Legal Business Name | EYEPRINT PROSTHETICS
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Dates
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Enumeration Date | 05/12/2014
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Last Update Date | 05/12/2014
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Provider Practice Location Address
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Address Line | 2221 OAK RD NE
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-9365
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Country | US
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Telephone | 541-915-4751
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Fax |
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Provider Business Mailing Address
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Address Line | 2221 OAK RD NE
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-9365
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Country | US
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Telephone | 541-915-4751
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KEITH D PARKER
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Credential |
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Telephone | 303-384-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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