Eyedentity PC

NPI #1639457864 in Johnston, Iowa

Provider Information

NPI Number: 1639457864
Entity Type: Organization
Organization Name: Eyedentity PC
Primary Specialty: Optometrist
Enumeration Date: Jul 21, 2011
Last Updated: Oct 17, 2011

Practice Location

Address: 5525 MERLE HAY RD STE 155
City: Johnston
State: Iowa
ZIP Code: 50131-1446
Phone: (515) 321-6332

Authorized Official

Name: DR. TARA J COOPER, OD
Title: PRESIDENT
Phone: (515) 321-6332

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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