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 | 2024-10-02 |