Provider Demographics
NPI:1265879290
Name:QC FAMILY EYE CARE PLLC
Entity type:Organization
Organization Name:QC FAMILY EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:R
Authorized Official - Last Name:KURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:563-359-5008
Mailing Address - Street 1:PO BOX 206
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61266-0206
Mailing Address - Country:US
Mailing Address - Phone:563-359-5008
Mailing Address - Fax:563-359-6241
Practice Address - Street 1:5811 ELMORE AVE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3513
Practice Address - Country:US
Practice Address - Phone:563-359-5008
Practice Address - Fax:563-359-6241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002577152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty