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General NPI Number Information
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NPI Number | 1861996191
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Entity Type | Organization
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Legal Business Name | ROGGY VISION CENTER, PLLC
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 708 5TH ST STE 1
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City | CORALVILLE
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State | IA
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Zip | 52241
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Country | US
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Telephone | 319-331-2192
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Fax |
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Provider Business Mailing Address
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Address Line | 708 5TH ST STE 1
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City | CORALVILLE
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State | IA
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Zip | 52241-2339
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Country | US
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Telephone | 319-569-1936
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Fax | 319-483-6597
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Authorized Official
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Title or Position | OPTOMETRIST/ OWNER
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Name | DR. SHERI LYN ROGGY
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Credential | O.D.
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Telephone | 319-569-1936
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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 | 20114
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License Number State | IA
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