| |
7440 Main St West, Webster, WI 54893 | |
(715) 866-4700 | |
(716) 571-0088 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 7440 Main St West, Webster, Wisconsin |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851421903 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 2589-035 (Wisconsin) | Primary |
152W00000X | Optometrist | 2608-035 (Wisconsin) | Secondary |
Mailing Address | Practice Location Address |
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Po Box 767, Saint Croix Falls, WI 54024-0767 Ph: (715) 483-3259 | 7440 Main St West, Webster, WI 54893 Ph: (715) 866-4700 |