NPI 1619161502 · live from the CMS NPI Registry
Kootenai Vision Centers PC
Optometrist in Eureka, MT. National Provider Identifier 1619161502, active.
NPI record
| NPI | 1619161502 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 602 Dewey Ave, Suite 300, Eureka, MT 59917 |
| Practice phone | 406-296-2507 |
| Mailing address | Po Box 960, Eureka, MT 59917 |
| Enumerated | September 4, 2007 |
| Last updated | February 12, 2008 |
| Authorized official | Steven Sorensen, Owner/Optometrist |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 495 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.