Organization
RUSS UPTOWN OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUGLAS PHILLIP MENTZER (PRESIDENT)
(515) 279-3189
Entity
Organization
Contact information
Practice address
4122 UNIVERSITY AVE, DES MOINES, IA 50311-3533
(515) 279-3189
(515) 279-3956
Mailing address
4122 UNIVERSITY AVE, DES MOINES, IA 50311-3533
(515) 279-3189
(515) 279-3956
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
04/10/2007
Last updated
12/28/2012
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