Individual
DR. ETHAN EVERETT HUISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1350 SE UNIVERSITY AVE, WAUKEE, IA 50263-8933
(515) 987-3937
(515) 987-3930
Mailing address
1350 SE UNIVERSITY AVE, WAUKEE, IA 50263-8933
(515) 987-3937
(515) 987-3930
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02216
IA
Other
Enumeration date
11/10/2005
Last updated
11/05/2021
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