Organization
FAMILY EYE CARE OF IDA GROVE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY L BROWN O.D. (PRESIDENT)
(712) 364-3118
Entity
Organization
Contact information
Practice address
415 2ND ST, IDA GROVE, IA 51445-1302
(712) 364-3118
(712) 364-4144
Mailing address
PO BOX 238, IDA GROVE, IA 51445-0238
(712) 364-3118
(712) 364-4144
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1792283
—
IA
Enumeration date
11/16/2005
Last updated
04/20/2008
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