Provider Demographics
NPI:1346645587
Name:BREUER EYE CARE
Entity Type:Organization
Organization Name:BREUER EYE CARE
Other - Org Name:NORTHWEST VISION CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/ MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONI
Authorized Official - Middle Name:R
Authorized Official - Last Name:BREUER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:515-450-3834
Mailing Address - Street 1:714 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-5730
Mailing Address - Country:US
Mailing Address - Phone:712-262-3982
Mailing Address - Fax:712-262-7831
Practice Address - Street 1:714 S GRAND AVE
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-5730
Practice Address - Country:US
Practice Address - Phone:712-362-3982
Practice Address - Fax:712-262-7831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002540152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1346645587Medicaid