Provider Demographics
NPI:1578246336
Name:WOLFE CLINIC EYE CENTERS LC
Entity type:Organization
Organization Name:WOLFE CLINIC EYE CENTERS LC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MOENCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-240-8721
Mailing Address - Street 1:309 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-2919
Mailing Address - Country:US
Mailing Address - Phone:641-754-6262
Mailing Address - Fax:641-754-6245
Practice Address - Street 1:219 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:IA
Practice Address - Zip Code:50525-1439
Practice Address - Country:US
Practice Address - Phone:515-532-3630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOLFE CLINIC EYE CENTERS LC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-09
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier