Organization
VISION SPECIALISTS OF COUNCIL BLUFFS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE CHEATHAM OD (OWNER)
(712) 322-3097
Entity
Organization
Contact information
Practice address
2514 W BROADWAY, COUNCIL BLUFFS, IA 51501-3509
(712) 322-3097
(712) 322-4130
Mailing address
2514 W BROADWAY, COUNCIL BLUFFS, IA 51501-3509
(712) 322-3097
(712) 322-4130
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
02/08/2008
Last updated
07/31/2018
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