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General NPI Number Information
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NPI Number | 1952537177
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Entity Type | Organization
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Legal Business Name | NANCY EKELUND EYECARE
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 2620 LARKSPUR LN SUITE L
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City | REDDING
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State | CA
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Zip | 96002-1044
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Country | US
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Telephone | 530-223-4300
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Fax | 530-222-8903
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Provider Business Mailing Address
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Address Line | 2620 LARKSPUR LN SUITE L
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City | REDDING
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State | CA
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Zip | 96002-1044
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Country | US
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Telephone | 530-223-4300
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Fax | 530-222-8903
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. NANCY C EKELUND
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Credential | OD
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Telephone | 530-223-4300
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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 | 7944T
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License Number State | CA
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