Individual
DR. MARK H STINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
401 N EDDY ST, GRAND ISLAND, NE 68801-4558
(308) 384-6922
(308) 384-7824
Mailing address
401 N EDDY ST, GRAND ISLAND, NE 68801-4558
(308) 384-6922
(308) 384-7824
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
865
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NE865
—
NE
Enumeration date
06/20/2005
Last updated
07/02/2010
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