| NPI | 1437144417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD R LEWELLEN Ophthalmologist/Vice President 920-684-4429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 156FX1800X Technician/Technologist, Optician | |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2009-11-19 |