Organization
NICKEL OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNETTE NICKEL (OWNER)
(740) 262-6857
Entity
Organization
Contact information
Practice address
1030 BLAIRS FERRY RD NE, CEDAR RAPIDS, IA 52402-1220
(319) 393-4459
Mailing address
208 SUNFLOWER DR, FAIRFAX, IA 52228-4731
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
002519
IA
Other
Enumeration date
07/28/2011
Last updated
07/28/2011
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