| |
1334 N. 4th Street, Suite 101, Tomahawk, WI 54487-2137 | |
(715) 224-2200 | |
(419) 858-9769 |
Full Name | |
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Type | Facility |
Speciality | Technician/technologist - Optician |
Location | 1334 N. 4th Street, Tomahawk, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225307242 | NPI | - | NPPES |
420969 | Medicaid | WI |
Provider Name | Roger S Lamoreux |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1487751939 PECOS PAC ID: 7810902830 Enrollment ID: I20060213000638 |
Mailing Address | Practice Location Address |
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1334 N 4th St Ste 101, Tomahawk, WI 54487-2106 Ph: (715) 224-2200 | 1334 N. 4th Street, Suite 101, Tomahawk, WI 54487-2137 Ph: (715) 224-2200 |