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Individual

DONOVAN L CROUCH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
600 ONTARIO ST, STORM LAKE, IA 50588-1845
(712) 732-3233
(712) 732-1866
Mailing address
701 WINTHROP CIR, STORM LAKE, IA 50588-2747
(712) 732-2456

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1470
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1082362
IA
Enumeration date
11/30/2005
Last updated
07/09/2007
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