| |
433 Florence Ave., Florence, WI 54121 | |
(715) 528-5331 | |
(715) 528-5332 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 433 Florence Ave., Florence, Wisconsin |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417179052 | NPI | - | NPPES |
38578900 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2242 (Wisconsin) | Primary |
Mailing Address | Practice Location Address |
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433 Florence Ave., Po Box 421, Florence, WI 54121 Ph: (715) 528-5331 | 433 Florence Ave., Florence, WI 54121 Ph: (715) 528-5331 |