Provider Demographics
NPI:1194593111
Name:ONE HOUR OPTICAL MEDICAL SERVICES, PC
Entity type:Organization
Organization Name:ONE HOUR OPTICAL MEDICAL SERVICES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HIEB
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:618-462-9818
Mailing Address - Street 1:111 E 4TH ST STE 440
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-6206
Mailing Address - Country:US
Mailing Address - Phone:618-462-9818
Mailing Address - Fax:314-741-4947
Practice Address - Street 1:2111 CUSTER DR
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2403
Practice Address - Country:US
Practice Address - Phone:970-224-9880
Practice Address - Fax:314-741-4947
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ONE HOUR OPTICAL MEDICAL SERVICES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty