Organization
FREEDOM LASER, L.L.C.
Active
Other names
Freedom Lasik,L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN TODD JENNINGS O.D (PRESIDENT)
(319) 758-1107
Entity
Organization
Contact information
Practice address
2743 MOUNT PLEASANT ST, BURLINGTON, IA 52601-2137
(319) 758-1107
(319) 758-6241
Mailing address
2743 MOUNT PLEASANT ST, BURLINGTON, IA 52601-2137
(319) 758-1107
(319) 758-6241
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
152W00000X
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31407
BLUE CROSS
IA
Enumeration date
01/05/2007
Last updated
08/01/2011
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