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General NPI Number Information
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NPI Number | 1447668280
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Entity Type | Individual
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Provider Name | MARGARET GRANGE O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 07/24/2014
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Provider Practice Location Address
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Address Line | 1103 GALVIN RD S H
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City | BELLEVUE
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State | NE
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Zip | 68005-3004
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Country | US
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Telephone | 402-292-6514
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Fax | 402-292-7122
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Provider Business Mailing Address
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Address Line | 900 FARNAM ST 315
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City | OMAHA
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State | NE
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Zip | 68102-5004
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Country | US
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Telephone | 402-321-5028
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1423
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License Number State | NE
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