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4097 Highway 28 Unit 2, Sheboygan Falls, WI 53085-2848 | |
(920) 458-5757 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Eyewear Supplier |
Location | 4097 Highway 28 Unit 2, Sheboygan Falls, Wisconsin |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
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1972169365 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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Po Box 19060, Green Bay, WI 54307-9060 Ph: () - | 4097 Highway 28 Unit 2, Sheboygan Falls, WI 53085-2848 Ph: (920) 458-5757 |