Individual
MARK E MATHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1700 PARK AVE, MUSCATINE, IA 52761-5434
(563) 263-2020
Mailing address
2682 TOM SAWYER RD, MUSCATINE, IA 52761-9755
(563) 263-0376
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1626
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3047431
—
IA
05
—
4047431
—
IA
Enumeration date
06/13/2005
Last updated
01/18/2008
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