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Individual

MELISSA JUNE HOGREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
4310 E 53RD ST, DAVENPORT, IA 52807-3039
(563) 322-1158
(563) 323-0949
Mailing address
310 W LOCUST ST, DAVENPORT, IA 52803-2806
(563) 322-1158
(563) 323-0949

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1977
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2133462
IA
01
37840
BLUE CROSS BLUE SHIELD
IA
Enumeration date
01/17/2006
Last updated
12/19/2019
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