MEDICARE: AMY HARTMANN EYE CARE, 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	:	1760090120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMY HARTMANN EYE CARE, LLC

Provider Business Mailing Address
First Line	:	3217 CEDAR HEIGHTS DR
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-6039
Country	:	US
Telephone Number	:	319-260-2620
Fax Number	:	319-260-2620

Provider Business Practice Location Address
First Line	:	3217 CEDAR HEIGHTS DR
Second Line	:
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-6039
Country	:	US
Telephone Number	:	319-260-2620
Fax Number	:	319-260-2620

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. DAWN MARIE POLLASTRINI
Credential	:	CPA
Telephone Number	:	319-352-2020

Provider Enumeration Date	:	07/21/2020
Last Update Date	:	07/21/2020

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