Individual
RICHARD SKOTOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 GLENN ST SE, MOUNT VERNON, IA 52314-1588
(319) 895-8888
(319) 895-8889
Mailing address
202 GLENN ST, MOUNT VERNON, IA 52314-0189
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1805
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030502
—
IA
01
—
22404
BLUE CROSS BLUE SHIELD
IA
Enumeration date
08/23/2005
Last updated
10/31/2008
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