Provider Demographics
NPI:1952923609
Name:LE MARS EYE CARE , PC
Entity type:Organization
Organization Name:LE MARS EYE CARE , PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDEKOP
Authorized Official - Suffix:
Authorized Official - Credentials:CPOA, CPOC
Authorized Official - Phone:712-943-9400
Mailing Address - Street 1:26 5TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3427
Mailing Address - Country:US
Mailing Address - Phone:712-546-6685
Mailing Address - Fax:
Practice Address - Street 1:26 5TH AVE NW
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3427
Practice Address - Country:US
Practice Address - Phone:712-943-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty