Individual
JOHN LACZKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2761 S 108TH ST, WEST ALLIS, WI 53227-3232
(414) 321-2425
(414) 321-4647
Mailing address
11103 WEST AVE, SUITE 6, SAN ANTONIO, TX 78213-1370
(210) 524-6663
(210) 524-6587
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1430-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38502300
—
WI
Enumeration date
12/27/2006
Last updated
07/09/2007
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