Provider Demographics
NPI:1720341415
Name:AMERICAN EYECARE PC
Entity Type:Organization
Organization Name:AMERICAN EYECARE PC
Other - Org Name:AMERICAN EYECARE PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:319-754-2020
Mailing Address - Street 1:2743 MOUNT PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-2137
Mailing Address - Country:US
Mailing Address - Phone:319-754-2020
Mailing Address - Fax:319-754-2823
Practice Address - Street 1:2000 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-9572
Practice Address - Country:US
Practice Address - Phone:319-754-2020
Practice Address - Fax:319-754-2823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty