Organization
CRESTON VISION CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD E MCKIM OD (OPTOMETRIST)
(641) 782-7619
Entity
Organization
Contact information
Practice address
1610 W TOWNLINE ST STE 115, CRESTON, IA 50801-1064
(641) 782-7619
(641) 782-6549
Mailing address
PO BOX 427, CRESTON, IA 50801-0427
(641) 782-7619
(641) 782-6549
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DF5361
RAILROAD MEDICARE
—
Enumeration date
10/11/2006
Last updated
02/21/2008
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