Provider Demographics
NPI:1548486434
Name:M J HOWIE OD PC
Entity type:Organization
Organization Name:M J HOWIE OD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOWIE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:515-986-1234
Mailing Address - Street 1:1451 SE 3RD ST.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-2057
Mailing Address - Country:US
Mailing Address - Phone:515-986-1234
Mailing Address - Fax:
Practice Address - Street 1:1451 SE 3RD ST.
Practice Address - Street 2:SUITE 400
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-2057
Practice Address - Country:US
Practice Address - Phone:515-986-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA02140152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty