Individual
TERRY DONN MOEHNKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
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
152W00000X
Optometrist
Primary
1649
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005843
—
IA
Enumeration date
09/07/2005
Last updated
02/27/2014
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