Organization
GRAND ISLAND OPTICAL PC
Active
Other names
Aurora Eyecare Professionals
Organization subpart
No
Provider details
NPI number
Authorized official
RENE DAWN KETTELER (BUSINESS MANAGER)
(308) 384-0220
Entity
Organization
Contact information
Practice address
1208 L ST, AURORA, NE 68818-2016
(402) 694-6114
Mailing address
PO BOX 128, AURORA, NE 68818-0128
(402) 694-6114
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025853800
—
NE
Enumeration date
06/04/2010
Last updated
10/07/2010
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