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Organization

EYEOWA OPTICAL COMPANY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN P GENKINGER (OWNER)
(641) 472-6694
Entity
Organization

Contact information

Practice address
122 N COURT ST, FAIRFIELD, IA 52556-2815
(641) 472-6694
(641) 472-5979
Mailing address
122 N COURT ST, FAIRFIELD, IA 52556-2815
(641) 472-6694
(641) 472-5979

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0263418
IA
Enumeration date
08/25/2008
Last updated
08/25/2008
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