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General NPI Number Information
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NPI Number | 1780678938
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Entity Type | Individual
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Provider Name | DAVID G VAINIO O.D.
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Gender | Male
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 09/14/2010
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Provider Practice Location Address
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Address Line | 100 W PARK AVE
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City | ANACONDA
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State | MT
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Zip | 59711-2259
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Country | US
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Telephone | 406-563-6471
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Fax | 406-563-7252
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Provider Business Mailing Address
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Address Line | 100 W PARK AVE
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City | ANACONDA
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State | MT
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Zip | 59711-2259
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Country | US
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Telephone | 406-563-6471
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Fax | 406-563-7252
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 426OPT
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0426
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License Number State | MT
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