Provider Demographics
NPI:1902533276
Name:HOWLIN VISION CLINIC, PC
Entity Type:Organization
Organization Name:HOWLIN VISION CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOLLIS-YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:605-332-2231
Mailing Address - Street 1:5129 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2670
Mailing Address - Country:US
Mailing Address - Phone:605-332-2231
Mailing Address - Fax:605-330-9519
Practice Address - Street 1:1700 S HIGHLINE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-1004
Practice Address - Country:US
Practice Address - Phone:605-274-7201
Practice Address - Fax:605-330-9519
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOWLIN VISION CLINIC, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty