Individual provider · NPI-1

Janson A Mancheski, OD

Optometrist · Shawano, WI

NPI number1780768333
StatusActive
Last updated in NPPESNov 5, 2009

Details

NPI
1780768333
Entity type
Individual (NPI-1)
Name
Janson A Mancheski
Credential
OD
Sex
Male
Sole proprietor
Yes
Enumeration date
Oct 24, 2006
Last updated
Nov 5, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X OptometristWI1750WIYes
152W00000X Optometrist1750WI

Practice location

1244 E Green Bay St
Janson Mancheski Od
Shawano, WI 54166-2208

Phone 715-526-2376 · Fax 715-526-9561

Mailing address

1244 E Green Bay St
Janson Mancheski Od
Shawano, WI 54166-2208

Phone 715-526-2376 · Fax 715-526-9561

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