Samuelson Eyecare LLC
Optometrist in Mount Horeb, WI. Organization (NPI-2).
NPI number1710072939
StatusActive
Last updated in NPPESOct 1, 2010
Details
- NPI
- 1710072939
- Entity type
- Organization (NPI-2)
- Legal business name
- Samuelson Eyecare LLC
- Organization subpart
- No
- Enumeration date
- Oct 4, 2006
- Last updated
- Oct 1, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Practice location
428 West Main StMount Horeb, WI 53572-2103
Phone 608-437-3377 · Fax 608-437-5063
Mailing address
428 West Main StPo Box 350
Mount Horeb, WI 53572-2103
Phone 608-437-3377 · Fax 608-437-5063
Authorized official
Lauren Ta-Samuelson
Optometrist
6084373377
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