| NPI | 1780053595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELYSE BRUNS Co Owner 715-892-2691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2024-04-25 |