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General NPI Number Information
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NPI Number | 1417902743
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Entity Type | Organization
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Legal Business Name | ADVANCED EYECARE, PC
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 4320 S MINNESOTA AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57105-6747
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Country | US
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Telephone | 605-331-2020
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Fax | 509-753-6855
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Provider Business Mailing Address
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Address Line | 4320 S MINNESOTA AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57105-6747
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Country | US
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Telephone | 605-331-2020
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Fax | 509-753-6855
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY JAMES BROWEN
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Credential | OD
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Telephone | 605-331-2020
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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 | T475
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License Number State | SD
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