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1124645585
MICHAEL JOSEPH BANNON
WATERTOWN, WI
NPI
1124645585
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
152W00000X Optometrist
(Licence: WI 3625-35)
Enumeration Date
2020-07-01
Last Update Date
2020-07-01
Business Address
Dr. MICHAEL JOSEPH BANNON OD
1500 S CHURCH ST
WATERTOWN, WI 53094-6404
Phone number: 920-261-9225
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Mailing Address
Dr. MICHAEL JOSEPH BANNON OD
700 POPLAR PATH
DELAFIELD, WI 53018-1828
Phone number: 262-490-7697
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