| NPI | 1013133065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANG B YANG Hr Manager & Provider Credentialing 414-977-3370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 152W00000X Optometrist |
| 207W00000X Ophthalmology | |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2025-07-25 |