Individual
JONATHAN KINGSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2514 W BROADWAY, COUNCIL BLUFFS, IA 51501-3509
(712) 322-3097
(712) 322-4130
Mailing address
2514 W BROADWAY, COUNCIL BLUFFS, IA 51501-3509
(712) 322-3097
(712) 322-4130
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046011741
IL
152W00000X
Optometrist
Primary
133101
IA
152W00000X
Optometrist
1669
NE
Other
Enumeration date
08/03/2023
Last updated
09/12/2025
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