Organization
INDEPENDENT OPTICAL DISPENSARY,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STANLEY E. DIERKS (CERTIFIED OPTICIAN)
(563) 243-1650
Entity
Organization
Contact information
Practice address
106 S 4TH ST, CLINTON, IA 52732-4425
(563) 243-1650
Mailing address
106 S 4TH ST, CLINTON, IA 52732-4425
(563) 243-1650
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
IA
Other
Enumeration date
03/24/2008
Last updated
10/17/2008
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