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General NPI Number Information
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NPI Number | 1780789537
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Entity Type | Organization
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Legal Business Name | LOVIK FAMILY EYECARE, P.C.
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 06/04/2010
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Provider Practice Location Address
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Address Line | 4151 4TH ST SW
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City | MASON CITY
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State | IA
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Zip | 50401-7346
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Country | US
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Telephone | 641-423-8431
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Fax | 641-423-8433
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Provider Business Mailing Address
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Address Line | 4151 4TH ST SW
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City | MASON CITY
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State | IA
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Zip | 50401-7346
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Country | US
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Telephone | 641-423-8431
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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. BRENDA S. LOVIK
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Credential | O.D.
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Telephone | 641-423-8431
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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 | 2098
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License Number State | IA
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