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Individual

REBECCA D AMARAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1923 N SHAWANO ST, SUITE B, NEW LONDON, WI 54961-7510
(920) 982-4561
(920) 982-9811
Mailing address
1923 N SHAWANO ST, SUITE B, NEW LONDON, WI 54961-7510
(920) 982-8561
(920) 982-9811

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2752
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38606100
WI
Enumeration date
10/05/2006
Last updated
11/19/2014
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