MEDICARE: ANGELA MARIE SPARTZ-KOLBO O. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	002547	IA

General Provider Information

NPI Number	:	1053666800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA MARIE SPARTZ-KOLBO O. D.

Provider Business Mailing Address
First Line	:	4600 SINGING HILLS BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106-9702
Country	:	US
Telephone Number	:	712-271-4600
Fax Number	:

Provider Business Practice Location Address
First Line	:	4600 SINGING HILLS BLVD
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51106-9702
Country	:	US
Telephone Number	:	712-271-4600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2012
Last Update Date	:	12/08/2015

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