| NPI | 1184727729 |
|---|---|
| Doing Business As | LAKE OPTICAL |
| Entity Type | Organization |
| Authorized Contact | VICKI SUE HEINSOHN Office Manager 715-234-1511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 152W00000X Optometrist |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2022-07-21 |