IndividualActive
Amanda Moore-Elcyzyn, O.D.
NPI 1780612499 · Optometrist · Benton, AR
Provider details
- NPI number
- 1780612499
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 2566 (AR)
Specialties & taxonomies
Eye and Vision Services Providers
Eye and Vision Services Providers
Practice location
113 W Carpenter St
Benton, AR 72015-3317
Phone: (501) 778-2363
Fax: (501) 778-5329
Approximate (ZIP-level) locationGet directions
Mailing address
1926 W State St
Boise, ID 83702-3957
Additional practice locations (1)
- 1926 W State StBoise, ID 83702-3957Phone: (208) 336-2020
Registry dates
- Enumerated
- 2006-06-29
- Last updated
- 2020-09-09
- Certified
- 2020-09-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.