| NPI | 1578606810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY R LAPORTE President 262-752-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 26907-020) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 44898-020) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2009-02-19 |