Organization
LAKEVIEW VISION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARRY DWAYNE KAPPEL O D (OWNER)
(541) 947-3357
Entity
Organization
Contact information
Practice address
628 N 1ST ST STE C, LAKEVIEW, OR 97630-1506
(541) 947-3357
(541) 947-3368
Mailing address
628 N 1ST ST STE C, LAKEVIEW, OR 97630-1506
(541) 947-3357
(541) 947-3368
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
961ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023632
—
OR
Enumeration date
11/22/2006
Last updated
11/19/2008
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