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General NPI Number Information
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NPI Number | 1598816555
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Entity Type | Organization
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Legal Business Name | OCULI VISION REHABILITATION, LLC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 1401 INFINITY RD STE B
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City | LINCOLN
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State | NE
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Zip | 68512-3713
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Country | US
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Telephone | 402-420-1177
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Fax | 402-420-1176
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Provider Business Mailing Address
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Address Line | 1401 INFINITY RD STE B
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City | LINCOLN
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State | NE
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Zip | 68512-3713
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Country | US
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Telephone | 402-420-1177
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Fax | 402-420-1176
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD & MANAGING PR
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Name | DR. JAMES L. NEDROW
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Credential | O.D. (OPTOMETRIST)
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Telephone | 402-420-1177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 2008026019
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 225XL0004X
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Taxonomy Name | Low Vision Occupational Therapist
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License Number | 2008004614
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 2007023592
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License Number State | MO
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2007023592
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License Number State | MO
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