| NPI | 1699710434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD DRAKE DAVENPORT President 414-328-8762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 19876) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2022-12-09 |