| NPI | 1306838487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY M SIPPLE Administrator 715-552-9337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2024-06-18 |