Organization
TKC OPTICAL
Active
Other names
EXACT EYE CARE
Organization subpart
No
Provider details
NPI number
Authorized official
CLARENCE JOSEPH VANDERLEI OD (MEDICAL DIRECTOR)
(712) 732-7624
Entity
Organization
Contact information
Practice address
100 E MILWAUKEE AVE, STORM LAKE, IA 50588-1813
(712) 732-7624
Mailing address
1801 4TH ST, SIOUX CITY, IA 51101-2118
(712) 732-7624
(712) 732-7627
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19004
AVESIS
—
01
—
21629
SPECTERA
IA
01
—
NE1143-03
EYEMED
—
Enumeration date
01/10/2007
Last updated
08/09/2021
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