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Individual

MINDY JANE DICKINSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
715 HARMONY STREET, SUITE 300, COUNCIL BLUFFS, IA 51503
(402) 552-2020
(402) 552-2367
Mailing address
4353 DODGE STREET, OMAHA, NE 68131-2709
(402) 552-2020
(402) 552-2367

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
1238
NE
152W00000X
Optometrist
Primary
2321
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0463646
IA
Enumeration date
11/16/2005
Last updated
04/11/2019
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