| NPI | 1811132830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARB WASCHBISCH President 920-499-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WI 2517) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WI 6198590001) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2009-05-21 |