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General NPI Number Information
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NPI Number | 1487637443
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Entity Type | Organization
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Legal Business Name | EYE HEALTH SOLUTIONS PC
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Dates
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Enumeration Date | 11/23/2005
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Last Update Date | 09/16/2009
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Provider Practice Location Address
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Address Line | 100 S 5TH ST
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City | KNOXVILLE
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State | IA
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Zip | 50138-1712
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Country | US
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Telephone | 641-842-4575
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Fax | 641-842-5453
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Provider Business Mailing Address
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Address Line | 100 S 5TH ST
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City | KNOXVILLE
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State | IA
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Zip | 50138-1712
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Country | US
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Telephone | 641-842-3616
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Fax | 641-842-5453
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JASON MAASDAM
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Credential | O.D.
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Telephone | 641-842-3616
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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 | 02116
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License Number State | IA
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