| NPI | 1548457302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR J BALDWIN Optometrist/Owner 608-837-7325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management |
| 156FX1201X Technician/Technologist, Optometric Assistant | |
| 156FX1800X Technician/Technologist, Optician | |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2021-02-22 |