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NPI 1124737622

NPI 1124737622 : OPTIMAL EYE CARE : LINCOLN, NE

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General NPI Number Information
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    NPI Number           |    1124737622
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    Entity Type          |    Organization 
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    Legal Business Name  |    OPTIMAL EYE CARE 
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Dates
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    Enumeration Date     |    11/23/2022
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    Last Update Date     |    11/23/2022
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Provider Practice Location Address
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    Address Line         |    5001 O ST STE F 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68510-1919
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    Country              |    US
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    Telephone            |    402-805-0397
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5001 O ST STE F 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68510-1919
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    Country              |    US
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    Telephone            |    402-805-0397
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OPTOMETRIST
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    Name                 |     ZACHERY  BAUMFALK 
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    Credential           |    
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    Telephone            |    402-805-0397
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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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