Organization
TERRY D. MOEHNKE, O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY D. MOEHNKE O.D. (PRESIDENT)
(515) 955-6720
Entity
Organization
Contact information
Practice address
25 S 16TH ST, FORT DODGE, IA 50501-5021
(515) 955-6720
(515) 955-3555
Mailing address
25 S 16TH ST, FORT DODGE, IA 50501-5021
(515) 955-6720
(515) 955-3555
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1649
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005843
—
IA
Enumeration date
05/08/2009
Last updated
09/24/2010
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