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General NPI Number Information
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NPI Number | 1669621264
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Entity Type | Organization
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Legal Business Name | ADVANCED FAMILY EYECARE ELKHORN P.C.
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 20330 VETERANS DR STE 4
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City | ELKHORN
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State | NE
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Zip | 68022-6929
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Country | US
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Telephone | 402-885-7695
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Fax | 402-884-2885
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Provider Business Mailing Address
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Address Line | 20330 VETERANS DR STE 4
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City | ELKHORN
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State | NE
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Zip | 68022-6929
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Country | US
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Telephone | 402-885-7695
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Fax | 402-884-2885
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LANI SUE MEADOWS
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Credential |
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Telephone | 402-884-0776
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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 | NE1146
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License Number State | NE
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