Organization
RIVERSIDE FAMILY EYE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA ANNE NIX OD (OPTOMETRIST)
(563) 289-2020
Entity
Organization
Contact information
Practice address
126 S CODY RD, LE CLAIRE, IA 52753-9236
(563) 289-2020
(563) 289-2011
Mailing address
PO BOX 6, LE CLAIRE, IA 52753-0006
(563) 289-2020
(563) 289-2011
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
2189
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1223669
—
IA
Enumeration date
10/17/2007
Last updated
07/24/2009
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