| NPI | 1063587038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA CREED Executive Director 414-321-7520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 207W00000X) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2026-02-04 |