| NPI | 1043513542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERINE N. JOHANNES Owner/O PT Ometrist 920-915-3422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1568) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2010-12-06 |