| NPI | 1043386600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE L BARFELS Biller 920-364-9213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2021-12-17 |