Organization
MOUNTAIN VALLEY VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CZERNY O.D. (OWNER)
(605) 390-7624
Entity
Organization
Contact information
Practice address
1236 NORTH AVE, SPEARFISH, SD 57783-1533
(605) 642-2645
Mailing address
1236 NORTH AVE, SPEARFISH, SD 57783-1533
(605) 642-2645
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
673
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9204090
—
SD
Enumeration date
12/30/2011
Last updated
06/13/2012
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