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Organization

MIDWEST VISION CLINIC PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN W PECK OD (OWNER OPTOMETRIST)
(563) 242-0223
Entity
Organization

Contact information

Practice address
425 S 2ND ST, CLINTON, IA 52732
(563) 242-0223
(563) 242-6864
Mailing address
425 S 2ND ST, CLINTON, IA 52732
(563) 242-0223
(563) 242-6864

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0183616
IA
01
48076
BLUECROSS BLUESHIELD
IA
Enumeration date
07/27/2006
Last updated
12/18/2007
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