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Eye and Vision Services Providers Optometrist

Provider NPI: 1023138922

Organization Information:
Organization Name:  WEST BEND OPTICAL, INC
Organization is not Subpart
Authorized Official:  SANDRA H. OLSON  VP  262-338-1800

Practice Location:
3720 W. WASHINGTON ST.  WEST BEND, WI 53095-8406 US
Tel: 262-338-1800  Fax: 262-338-1947

Business Mailing Address:
3720 W. WASHINGTON ST.  WEST BEND, WI 53095-8406 US
Tel: 262-338-1800  Fax: 262-338-1947

NPI Information:
NPI: 1023138922
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
N152W00000XEye and Vision Services Providers
Y156F00000XEye and Vision Services Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 156F00000X





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