Organization
ELWOOD M YOUNG OD PC
Active
Other names
Young Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACQUE DIANE YOUNG OD (OWNER)
(712) 527-4468
Entity
Organization
Contact information
Practice address
406 1ST ST, GLENWOOD, IA 51534-1706
(712) 527-4468
(712) 527-9458
Mailing address
406 1ST ST, PO BOX 188, GLENWOOD, IA 51534-1706
(712) 527-4468
(712) 527-9458
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01809
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0038547
—
IA
01
—
410015491
RAILROAD MEDICARE
IA
Enumeration date
03/23/2007
Last updated
11/09/2011
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