Individual
MRS. LILY MARK -MAASDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
100 S 5TH ST, KNOXVILLE, IA 50138-1712
(641) 842-3616
(641) 842-5453
Mailing address
100 S 5TH ST, KNOXVILLE, IA 50138-1712
(641) 842-3616
(641) 842-5453
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02111
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1186106
—
IA
01
—
48881
BLUE CROSS
IA
Enumeration date
11/23/2005
Last updated
07/08/2007
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