Organization
FAMILY VISION CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEAN L LAURITZEN O.D. (OWNER)
(402) 529-3558
Entity
Organization
Contact information
Practice address
1024 AVENUE E, WISNER, NE 68791-2248
(402) 529-3558
Mailing address
1024 AVENUE E, P.O. BOX 367, WISNER, NE 68791-2248
(402) 529-3558
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
767
NE
261Q00000X
Clinic/Center
767
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25136
WISNER COVENTRY PAYOR ID
NE
01
—
7748
WISNER BLUE CROSS
NE
01
—
8422
WISNER MIDLANDS CHOICE
NE
Enumeration date
11/01/2006
Last updated
10/04/2010
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