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General NPI Number Information
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NPI Number | 1538365481
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Entity Type | Organization
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Legal Business Name | PRECISION VISION PC
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 01/18/2013
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Provider Practice Location Address
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Address Line | 724 N DIERS AVE
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City | GRAND ISLAND
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State | NE
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Zip | 68803-4954
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Country | US
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Telephone | 308-384-9505
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Fax | 308-384-4939
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Provider Business Mailing Address
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Address Line | 724 N DIERS AVE
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City | GRAND ISLAND
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State | NE
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Zip | 68803-4954
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Country | US
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Telephone | 308-384-9505
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Fax | 308-384-4939
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TAMARA LYNN BONNES
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Credential | O.D.
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Telephone | 308-384-9505
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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 | NE1041
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License Number State | NE
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