Provider Demographics
NPI:1215210737
Name:VISION CARE CLINIC PC
Entity Type:Organization
Organization Name:VISION CARE CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHRUNK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:712-873-3440
Mailing Address - Street 1:223 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:51039-7814
Mailing Address - Country:US
Mailing Address - Phone:712-873-3440
Mailing Address - Fax:712-873-3442
Practice Address - Street 1:223 MAIN ST
Practice Address - Street 2:
Practice Address - City:MOVILLE
Practice Address - State:IA
Practice Address - Zip Code:51039-7814
Practice Address - Country:US
Practice Address - Phone:712-873-3440
Practice Address - Fax:712-873-3442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty