Organization
INTERNATIONAL EYECARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ALLISON (MVC DIRECTOR)
(314) 741-8183
Entity
Organization
Contact information
Practice address
125 N 13TH ST, CENTERVILLE, IA 52544-1705
(641) 437-4099
(641) 437-4099
Mailing address
125 N 13TH ST, CENTERVILLE, IA 52544-1705
(641) 437-4099
(641) 437-4099
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760405047
—
IA
Enumeration date
01/23/2013
Last updated
01/20/2021
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