Organization
HOLDREGE FAMILY VISION CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE E QUINCY OD (OWNER/PRES)
(308) 995-8697
Entity
Organization
Contact information
Practice address
503 MCMILLAN STREET, HOLDREGE, NE 68949-0920
(308) 995-8697
Mailing address
503 MCMILLAN STREET, PO BOX 920, HOLDREGE, NE 68949-0920
(308) 995-8697
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
831
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0269890002
NORIDIAN DMERC
ND
Enumeration date
10/10/2006
Last updated
09/02/2009
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