| NPI | 1245164219 |
|---|---|
| Doing Business As | SHOPKO OPTICAL 4322 |
| Entity Type | Organization |
| Authorized Contact | DIRK-JAN HEHENKAMP CEO 920-429-7285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2026-06-12 |
| Last Update Date | 2026-06-12 |