Organization
MANDY O.D., P.C.
Active
Other names
Optical Gallery
Organization subpart
No
Provider details
NPI number
Authorized official
MANDY JANE JOHNSON (OWNER/OPTOMETRIST)
(308) 234-9913
Entity
Organization
Contact information
Practice address
220 W 39TH ST, KEARNEY, NE 68845-2802
(308) 234-9913
(308) 234-4006
Mailing address
5403 N AVE, KEARNEY, NE 68847-8514
(308) 234-9133
(308) 234-4006
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1220
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025556000
—
NE
01
—
37173
BCBS
—
Enumeration date
10/24/2007
Last updated
11/12/2021
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