# JACOBSON OPTOMETRY LTD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255518635
- **Authorized official:** DR. KEVIN E JACOBSON O.D. (DOCTOR)
- **Authorized official phone:** (715) 234-3113

## Contact information

- **Practice address:** 1801 W KNAPP ST STE 3, RICE LAKE, WI 54868-1381
- **Practice address phone:** (715) 234-3113
- **Practice address fax:** (715) 234-2339
- **Mailing address:** 1801 W KNAPP ST STE 3, RICE LAKE, WI 54868-1381
- **Mailing address phone:** (715) 234-3113
- **Mailing address fax:** (715) 234-2339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/28/2008
- **Last updated:** 01/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 38527700 | — | WI |