Organization
KINGSLEY VISION CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS ROY VANNATTA OD (PRESIDENT)
(712) 378-2640
Entity
Organization
Contact information
Practice address
125 MAIN STREET, KINGSLEY, IA 51028
(712) 378-2640
(712) 378-3740
Mailing address
PO BOX 129, KINGSLEY, IA 51028-0129
(712) 378-2640
(712) 378-3740
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
IA1725
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0177410
—
IA
Enumeration date
10/24/2006
Last updated
06/27/2008
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