Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 110 8th St, Monroe, Wisconsin |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1326604711 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Po Box 19060, Green Bay, WI 54307-9060 Ph: () - | 110 8th St, Monroe, WI 53566-1050 Ph: (608) 328-3333 |