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General NPI Number Information
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NPI Number | 1174933584
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Entity Type | Organization
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Legal Business Name | THE LASIK VISION LLC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 05/07/2014
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Provider Practice Location Address
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Address Line | 1225 JORDAN CREEK PARKWAY SUITE 104
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City | WEST DES MOINES
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State | IA
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Zip | 50266
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Country | US
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Telephone | 515-221-8950
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 PALM BEACH LAKES BLVD SUITE 800
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City | WEST PLAM BEACH
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State | FL
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Zip | 33409
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Country | US
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Telephone | 800-584-4150
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BEN COOK
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Credential |
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Telephone | 800-584-4150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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