Organization
REVERIE OPTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH L BARON O.D. (OWNER)
(262) 786-4144
Entity
Organization
Contact information
Practice address
2205 N CALHOUN RD STE 16, BROOKFIELD, WI 53005-5062
(262) 786-4144
(262) 786-4729
Mailing address
2205 N CALHOUN RD STE 16, BROOKFIELD, WI 53005-5062
(262) 786-4144
(262) 786-4729
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2942
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38714200
—
WI
Enumeration date
01/19/2007
Last updated
12/07/2018
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