| NPI | 1508242256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL BARDENWERPER Owner/Sole Member 262-366-6370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 325735) |
| Enumeration Date | 2015-08-05 |
| Last Update Date | 2015-08-05 |