Watertown Vision, LLC
Optometrist in Watertown, WI. Organization (NPI-2).
NPI number1780935957
StatusActive
Last updated in NPPESSep 27, 2012
Details
- NPI
- 1780935957
- Entity type
- Organization (NPI-2)
- Legal business name
- Watertown Vision, LLC
- Organization subpart
- No
- Enumeration date
- Sep 27, 2012
- Last updated
- Sep 27, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Practice location
1640 S Church StWatertown, WI 53094-6406
Phone 920-390-2971 · Fax 920-390-2974
Mailing address
1640 S Church StWatertown, WI 53094-6406
Phone 920-390-2971 · Fax 920-390-2974
Authorized official
Jason Procto
Owner/Operator
4148108003
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