Individual
DR. TODD RANDALL PIETIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
12871 UNIVERSITY AVE, SUITE 140, CLIVE, IA 50325-8255
(712) 830-6806
(515) 221-9196
Mailing address
4105 SW BLUEGRASS DR, ANKENY, IA 50023-8280
(712) 830-6806
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002405
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3701163
—
IA
Enumeration date
08/05/2007
Last updated
02/25/2011
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