Organization
GLE GLENWOOD LLC
Active
Other names
Young Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN DERENE MIHULKA (OFFICE MANAGER)
(712) 520-2759
Entity
Organization
Contact information
Practice address
406 1ST ST, GLENWOOD, IA 51534-1706
(712) 527-4468
(712) 527-9458
Mailing address
PO BOX 188, GLENWOOD, IA 51534-0188
(712) 527-4468
(712) 527-9458
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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