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ADVANCED EYE CARE, LLC

Eye and Vision Services Providers Optometrist

Provider NPI: 1922343680

Organization Information:
Organization Name:  ADVANCED EYE CARE, LLC
Organization is not Subpart
Authorized Official:  NATHAN  BOLEN  OPTOMETRIST  402-462-9191

Practice Location:
1414 W 12TH ST  HASTINGS, NE 68901-3742 US
Tel: 402-462-9191  Fax: 402-462-9192

Business Mailing Address:
1414 W 12TH ST  HASTINGS, NE 68901-3742 US
Tel: 402-462-9191  Fax: 402-462-9192

NPI Information:
NPI: 1922343680
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
NE

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 152W00000X

Type:

Classification:



Definition:



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