MEDICARE: LINN COUNTY EYE CARE PLC

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

General Provider Information

NPI Number	:	1073867982
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINN COUNTY EYE CARE PLC

Provider Business Mailing Address
First Line	:	915 ROBINS SQUARE DR
Second Line	:
City	:	ROBINS
State	:	IA
Zip	:	52328-9649
Country	:	US
Telephone Number	:	319-294-8888
Fax Number	:	319-294-4299

Provider Business Practice Location Address
First Line	:	510 10TH ST SE
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52403-1207
Country	:	US
Telephone Number	:	319-365-2868
Fax Number	:	319-365-7831

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DAVID W CHRISTENSEN
Credential	:	OD
Telephone Number	:	319-294-8888

Provider Enumeration Date	:	10/30/2012
Last Update Date	:	10/30/2012

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