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General NPI Number Information
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NPI Number | 1386977544
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Entity Type | Organization
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Legal Business Name | HANSEL FAMILY EYECARE, P.C.
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Dates
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Enumeration Date | 09/04/2009
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Last Update Date | 09/04/2009
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Provider Practice Location Address
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Address Line | 320 W KIMBERLY RD STE. #28
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City | DAVENPORT
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State | IA
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Zip | 52806-5920
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Country | US
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Telephone | 563-386-1950
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Fax | 563-386-1021
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Provider Business Mailing Address
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Address Line | 320 W KIMBERLY RD STE. #28
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City | DAVENPORT
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State | IA
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Zip | 52806-5920
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Country | US
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Telephone | 563-386-1950
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Fax | 563-386-1021
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. BRIAN DAVID HANSEL
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Credential | O.D.
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Telephone | 563-386-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 002466
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License Number State | IA
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