Provider Demographics
NPI:1407037443
Name:HOWLIN VISION CLINIC, P.C.
Entity Type:Organization
Organization Name:HOWLIN VISION CLINIC, P.C.
Other - Org Name:EYE-SITE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SLOTHOUBER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:605-428-5701
Mailing Address - Street 1:5129 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2670
Mailing Address - Country:US
Mailing Address - Phone:605-332-2231
Mailing Address - Fax:605-330-9519
Practice Address - Street 1:436 E 4TH ST
Practice Address - Street 2:
Practice Address - City:DELL RAPIDS
Practice Address - State:SD
Practice Address - Zip Code:57022-1928
Practice Address - Country:US
Practice Address - Phone:605-428-5701
Practice Address - Fax:605-330-9519
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOWLIN VISION CLINIC, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-19
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD0274680002Medicare NSC