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General NPI Number Information
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NPI Number | 1740720333
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Entity Type | Organization
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Legal Business Name | ALTUS FAMILY VISION, PLLC
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 112 VAL VERDE ST STE C
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City | ALTUS
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State | OK
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Zip | 73521-1190
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Country | US
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Telephone | 580-482-0051
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Fax | 580-482-7746
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Provider Business Mailing Address
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Address Line | 112 VAL VERDE ST STE C
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City | ALTUS
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State | OK
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Zip | 73521-1190
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Country | US
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Telephone | 580-482-0051
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Fax | 580-482-7746
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. AMIE STRAUB
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Credential | OD
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Telephone | 580-482-0051
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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 | 2505
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License Number State | OK
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