Organization · Type 2 NPI
Lake Avenue Eyecare LLC
Eyewear Supplier · Gothenburg, NE
NPI number
1396932430
Active
Practice location
829 Lake Ave
Gothenburg, NE 69138-1943
Fax (308) 537-3391
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist | 152W00000X | 1166 (NE) |
| Eyewear Supplier Primary | 332H00000X | 1166 (NE) |
Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Another provider at this address
Other eyewear supplier providers in Gothenburg
About NPI 1396932430
Lake Avenue Eyecare LLC's National Provider Identifier is 1396932430, issued on Oct 3, 2007. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Gothenburg, NE. The record was last updated on Oct 27, 2022.