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General NPI Number Information
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NPI Number | 1962453779
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Entity Type | Organization
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Legal Business Name | OPTOMETRIC ASSOCIATES OF WARREN COUNTY PC
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 02/04/2014
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Provider Practice Location Address
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Address Line | 1228 SUNSET DR STE A
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City | NORWALK
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State | IA
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Zip | 50211-2401
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Country | US
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Telephone | 515-981-0224
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Fax | 515-981-5389
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Provider Business Mailing Address
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Address Line | 1228 SUNSET DR STE A
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City | NORWALK
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State | IA
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Zip | 50211-2401
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Country | US
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Telephone | 515-981-0224
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Fax | 515-981-5389
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Authorized Official
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Title or Position | PRESIDENT
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Name | CRAIG A WINJUM
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Credential | OD
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Telephone | 515-961-5305
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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 |
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License Number State |
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