Individual
DR. ELIZABETH KAY GROETKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
16 CENTRAL AVE NE, LE MARS, IA 51031-3515
(712) 546-8998
(712) 546-8971
Mailing address
16 CENTRAL AVE NE, PO BOX 706, LE MARS, IA 51031-3515
(712) 546-8998
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5431
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0135230002
CIGNA MEDICARE
IA
01
—
11206
MIDLANDS
IA
05
—
2195669
—
IA
01
—
28406
BCBS
IA
Enumeration date
05/22/2006
Last updated
10/16/2007
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