Provider Demographics
NPI:1417769167
Name:IOWA VISION LLC
Entity type:Organization
Organization Name:IOWA VISION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DERBY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:319-551-2793
Mailing Address - Street 1:2347 SWITCH GRASS WAY
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80109-4537
Mailing Address - Country:US
Mailing Address - Phone:319-551-2793
Mailing Address - Fax:
Practice Address - Street 1:101 E 10TH ST
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:IA
Practice Address - Zip Code:52310-1034
Practice Address - Country:US
Practice Address - Phone:319-551-2793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty