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General NPI Number Information
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NPI Number | 1588849848
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Entity Type | Organization
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Legal Business Name | VISION CARE CLINIC PC
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 10/18/2023
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Provider Practice Location Address
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Address Line | 210 S 17TH ST
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City | BLAIR
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State | NE
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Zip | 68008-2055
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Country | US
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Telephone | 402-426-2119
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Fax | 402-426-2120
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Provider Business Mailing Address
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Address Line | 210 S 17TH ST
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City | BLAIR
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State | NE
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Zip | 68008-2055
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Country | US
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Telephone | 402-426-2119
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Fax | 402-426-2120
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Authorized Official
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Title or Position | CO PRESIDENT
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Name | DR. SCOTT A BOWKER
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Credential | OD
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Telephone | 712-263-2020
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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 | 01624
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License Number State | IA
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