Lake Avenue Eyecare LLC
NPI #1396932430 in Gothenburg, Nebraska
Provider Information
- NPI Number
- 1396932430
- Entity Type
- Organization
- Organization Name
- Lake Avenue Eyecare LLC
- Primary Specialty
- Eyewear Supplier
- Enumeration Date
- Oct 3, 2007
- Last Updated
- Oct 27, 2022
Practice Location
- Address
- 829 LAKE AVE
- City
- Gothenburg
- State
- Nebraska
- ZIP Code
- 69138-1943
- Phone
- (308) 537-3390
Authorized Official
- Name
- DR. JOHN A GOSNELL, O.D.
- Title
- OWNER
- Phone
- (308) 537-3390
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
| Eyewear Supplier |
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