| NPI | 1457501868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY NICHOLAS WILSON President/Optometrist 608-226-8656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 3108-035) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2008-09-22 |