| NPI | 1407079981 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA G JOHNSON Optometrist President 262-886-4629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 2246035) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |