Organization
ELLINGSON EYECARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY D ELLINGSON O.D. (OWNER)
(319) 466-0644
Entity
Organization
Contact information
Practice address
1451 CORAL RIDGE AVE STE 518, CORALVILLE, IA 52241-2805
(319) 466-0644
(319) 466-0330
Mailing address
1451 CORAL RIDGE AVE STE 518, CORALVILLE, IA 52241-2805
(319) 466-0644
(319) 466-0330
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130740
EYEMED
IA
01
—
244542
MIDLAND'S CHOICE
IA
01
—
25241
AVESIS
IA
05
—
259168
—
IA
01
—
45844
WELLMARK BLUE CROSS BLUE
IA
Enumeration date
07/12/2007
Last updated
07/12/2007
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