Organization
WAKAN VISION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A COOLEY (PRESIDENT)
(402) 898-3232
Entity
Organization
Contact information
Practice address
10826 OLD MILL RD STE 101, OMAHA, NE 68154-2660
(402) 898-3232
Mailing address
10826 OLD MILL RD STE 101, OMAHA, NE 68154-2660
(402) 898-3232
(402) 898-3234
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2277
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025795600
—
NE
05
—
1871542241
—
IA
05
—
33629013
—
CO
Enumeration date
05/10/2006
Last updated
03/17/2018
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