Broadway Vision Source, Incorporated
NPI #1710456249 in Eagle Grove, Iowa
Provider Information
- NPI Number
- 1710456249
- Entity Type
- Organization
- Organization Name
- Broadway Vision Source, Incorporated
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- BROADWAY VISION SOURCE, INCORPORATED
- Primary Specialty
- Optometrist
- Enumeration Date
- Nov 14, 2018
- Last Updated
- Nov 14, 2018
Practice Location
- Address
- 300 W BROADWAY ST
- City
- Eagle Grove
- State
- Iowa
- ZIP Code
- 50533-1712
- Phone
- (515) 448-3813
Authorized Official
- Name
- BRANDON S HAUCK, O.D
- Title
- OWNER
- Phone
- (515) 448-3813
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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