Provider Demographics
NPI:1851008841
Name:ROWAN OPTOMETRY PC
Entity Type:Organization
Organization Name:ROWAN OPTOMETRY PC
Other - Org Name:EYE ZONE-CARSON CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHITSCH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:775-287-8046
Mailing Address - Street 1:3333 QUALITY DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7985
Mailing Address - Country:US
Mailing Address - Phone:704-712-0564
Mailing Address - Fax:
Practice Address - Street 1:911 TOPSY LN STE 236
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89705-8405
Practice Address - Country:US
Practice Address - Phone:775-267-9160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty