Organization
PROFESSIONAL EYECARE CENTERS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACI JO RUDOLPH (ACCOUNTS SPECIALIST)
(701) 252-5000
Entity
Organization
Contact information
Practice address
210 10TH ST SE, JAMESTOWN, ND 58401-5553
(701) 252-5000
(701) 952-5005
Mailing address
210 10TH ST SE, JAMESTOWN, ND 58401-5553
(701) 252-5000
(701) 952-5005
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60490
—
ND
Enumeration date
09/27/2006
Last updated
06/14/2021
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