Mark Leroy Bottelson O.D.

NPI 1689859704 - Optometrist - 152W00000X

NPI Details
NPI 1689859704
Gender Male
Enumeration Date 01/08/2008
Last Updated 07/13/2009
Entity Type Individual
Active Over 8 years ago
Practice Location
1001 73RD ST
VISION CENTER
WINDSOR HEIGHTS IA, 50324-1311, US
Phone (515) 274-6452
Fax (515) 274-6306
Business Location
1001 73RD ST
VISION CENTER
WINDSOR HEIGHTS IA, 50324-1311, US
Phone (515) 274-6452
Fax (515) 274-6306
Toxanomy
Taxonomy Code 152W00000X
License State Iowa
License Number 01684
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According to our database, Mark Leroy Bottelson O.D. NPI is 1689859704, taxonomy code is 152W00000X and license number is 01684, license state is located at Iowa. Mark Leroy Bottelson O.D. physically located at 1001 73rd St, Windsor Heights IA, 50324-1311. NPI Number Mark Leroy Bottelson O.D. has the Individual type.

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1689859704 NPI number is provided on an as is basis without warranty of any kind. 1689859704 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Leroy Bottelson O.D. are for informational purposes only.