Organization
ALLIANCE VISION SOURCE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAMARA V FRANKLLIN CPOT (OFFICE ADMINISTRATOR)
(308) 762-3124
Entity
Organization
Contact information
Practice address
515 NIOBRARA AVE, ALLIANCE, NE 69301-3421
(308) 762-3124
(308) 762-7326
Mailing address
PO BOX 490, ALLIANCE, NE 69301-0490
(308) 762-3124
(308) 762-7326
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025031600
—
NE
01
—
205248
EYEMED VISION
NE
01
—
DA9238
RAILROAD MEDICARE
NE
Enumeration date
06/29/2006
Last updated
02/06/2008
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