Individual
KAILA CYNTHIA EGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
918 DECATHLON DR, WATERLOO, IA 50701-3441
(319) 236-2020
Mailing address
918 DECATHLON DR, WATERLOO, IA 50701-3441
(319) 236-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002596
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
IB2898001
—
IA
Enumeration date
06/07/2013
Last updated
11/18/2013
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