Organization
EYECARE ASSOCIATES OF SOUTHWEST IOWA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY L SAMUELSON O.D. (SECRETARY/TREASURER/OWNER)
(712) 542-6513
Entity
Organization
Contact information
Practice address
116 E WASHINGTON ST, CLARINDA, IA 51632-1611
(712) 542-6513
(712) 542-2274
Mailing address
116 E WASHINGTON ST, CLARINDA, IA 51632-1611
(712) 542-6513
(712) 542-2274
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0201285
—
IA
01
—
07311
BCBS
IA
05
—
100249544-00
—
NE
01
—
109192
EYEMED
—
Enumeration date
11/02/2005
Last updated
08/03/2012
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