Organization
VISION SOURCE RAPID CITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWAYNE ROBERT ICE OD (OPTOMETRIST)
(605) 343-4703
Entity
Organization
Contact information
Practice address
825 COLUMBUS ST STE E, RAPID CITY, SD 57701-4804
(605) 343-4703
(605) 721-7201
Mailing address
825 COLUMBUS ST STE E, RAPID CITY, SD 57701-4804
(605) 343-4703
(605) 721-7201
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9201450
—
SD
Enumeration date
10/01/2020
Last updated
10/01/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us