| NPI | 1336024025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI BERTINO Credentialing 414-294-4660 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 152W00000X Optometrist | |
| 152WV0400X Optometrist, Vision Therapy | |
| 207WX0009X Ophthalmology, Glaucoma Specialist | |
| 207WX0120X Ophthalmology, Cornea and External Diseases Specialist | |
| Enumeration Date | 2025-08-11 |
| Last Update Date | 2025-08-11 |