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General NPI Number Information
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NPI Number | 1760636807
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Entity Type | Organization
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Legal Business Name | SEWARD VISION CLINIC, P.C.
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 02/24/2009
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Provider Practice Location Address
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Address Line | 236 S COLUMBIA AVE
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City | SEWARD
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State | NE
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Zip | 68434-2206
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Country | US
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Telephone | 402-643-2944
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Fax |
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Provider Business Mailing Address
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Address Line | 236 S COLUMBIA AVE PO BOX 129
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City | SEWARD
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State | NE
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Zip | 68434-2206
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Country | US
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Telephone | 402-643-2944
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CRAIG ALAN SLEPICKA
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Credential | OD
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Telephone | 402-643-2944
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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 | 1050
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License Number State | NE
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