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General NPI Number Information
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NPI Number | 1285992362
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Entity Type | Organization
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Legal Business Name | DOUGLAS C. SPYRISON, OD
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 1705 DELHI ST
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City | DUBUQUE
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State | IA
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Zip | 52001-5900
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Country | US
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Telephone | 563-588-4651
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Fax | 563-557-1073
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Provider Business Mailing Address
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Address Line | 1705 DELHI ST
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City | DUBUQUE
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State | IA
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Zip | 52001-5900
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Country | US
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Telephone | 563-588-4651
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Fax | 563-557-1073
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DOUGLAS C SPYRISON
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Credential | O.D.
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Telephone | 563-588-4651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 1760
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License Number State | IA
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