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General NPI Number Information
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NPI Number | 1396185005
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Entity Type | Organization
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Legal Business Name | IOWA VALLEY EYE CARE PLC
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 1022 COURT AVE
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City | MARENGO
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State | IA
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Zip | 52301-1438
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Country | US
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Telephone | 319-642-3311
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Fax | 319-642-7111
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Provider Business Mailing Address
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Address Line | PO BOX 204
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City | MARENGO
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State | IA
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Zip | 52301-0204
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Country | US
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Telephone | 319-642-3311
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. PATRICK JOHN FLEMING
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Credential | O.D.
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Telephone | 319-642-3311
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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 | 002433
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License Number State | IA
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