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General NPI Number Information
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NPI Number | 1265578652
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Entity Type | Organization
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Legal Business Name | CLEAR FOCUS EYECARE LLC
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 1225 S POPLAR ST SUITE 400
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City | NORTH PLATTE
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State | NE
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Zip | 69101-7785
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Country | US
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Telephone | 308-534-7100
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Fax | 308-534-5002
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Provider Business Mailing Address
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Address Line | 1225 S POPLAR ST SUITE 400
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City | NORTH PLATTE
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State | NE
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Zip | 69101-7785
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Country | US
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Telephone | 308-534-7100
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Fax | 308-534-5002
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JOHN J GUTSCHENRITTER
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Credential | OD
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Telephone | 308-534-7100
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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 | 988
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License Number State | NE
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