MEDICARE: CLEAR VIEW VISION CENTER, LLC

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	:	1508489824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR VIEW VISION CENTER, LLC

Provider Business Mailing Address
First Line	:	1001 AVENUE H STE 2
Second Line	:
City	:	FORT MADISON
State	:	IA
Zip	:	52627-4559
Country	:	US
Telephone Number	:	319-316-6016
Fax Number	:	319-669-8335

Provider Business Practice Location Address
First Line	:	1001 AVENUE H STE 2
Second Line	:
City	:	FORT MADISON
State	:	IA
Zip	:	52627-4559
Country	:	US
Telephone Number	:	773-329-3253
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	MR. ANTHONY KEITH MENKE
Credential	:
Telephone Number	:	319-316-6016

Provider Enumeration Date	:	05/20/2020
Last Update Date	:	01/13/2021

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