Provider Demographics
NPI:1760790430
Name:SCHLATTER, CHET ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHET
Middle Name:ALAN
Last Name:SCHLATTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-1636
Mailing Address - Country:US
Mailing Address - Phone:641-628-2023
Mailing Address - Fax:641-628-2031
Practice Address - Street 1:1940 VENTURE DR
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-3766
Practice Address - Country:US
Practice Address - Phone:641-683-6111
Practice Address - Fax:641-628-2031
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002492152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA002492OtherSTATE LICENSE