Provider Demographics
NPI:1528590742
Name:CENTRAL VISION CENTER OF IOWA LLC
Entity Type:Organization
Organization Name:CENTRAL VISION CENTER OF IOWA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:641-780-7634
Mailing Address - Street 1:119 1ST AVE W
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-3243
Mailing Address - Country:US
Mailing Address - Phone:641-673-5658
Mailing Address - Fax:641-673-0979
Practice Address - Street 1:119 1ST AVE W
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-3243
Practice Address - Country:US
Practice Address - Phone:641-673-5658
Practice Address - Fax:641-673-0979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01757152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty