Organization Name: | IOWA EYE PROSTHETICS INC |
NPI Number: | 1063447217 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DAVID MICHAEL BULGARELLI (PRESIDENT OCULARIST) |
Mailing Address: | 625 First Avenue Ste 200 Coralville |
State: | IA US |
Postal Code: | 52241 |
Phone Number: | 3193543434 |
Fax Number: | 3193543465 |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Ocularist |
Taxonomy Definition: |