Dehaan, Ralph Jacob

Dehaan, Ralph Jacob is an individual health care provider with primary practice located at 823 Franklin St , Pella IA 50219-1603. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dehaan, Ralph Jacob can be contacted via phone (641) 628-9225.

Contact Information

Primary practice address
823 Franklin St Pella IA 50219-1603
Phone: (641) 628-9225
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1831 Iowa

Profile Details

NPI number 1790763811
LBN Legal business name Dehaan, Ralph Jacob
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2006
Last updated Dec 12th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790763811 NPPES
Iowa MEDICAID 0160770

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