Organization
EAGLE MOUNTAIN EYE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN VANCE O.D. (PRESIDENT)
(573) 382-2974
Entity
Organization
Contact information
Practice address
3150 HARRISON ST, BATESVILLE, AR 72501-7515
(870) 793-6544
(870) 793-7024
Mailing address
3150 HARRISON ST, BATESVILLE, AR 72501-7515
(870) 793-6544
(870) 793-7024
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2657
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187164722
—
AR
Enumeration date
06/20/2012
Last updated
06/20/2012
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