Individual
DR. CASSANDRE BEZOLD HETZER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
935 HORICON ST, MAYVILLE, WI 53050-1428
(920) 387-3180
(920) 387-9636
Mailing address
614 COLGATE RD, COLGATE, WI 53017-9323
(262) 628-2123
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2915-035
WI
152W00000X
Optometrist
OPT002017
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
386-17900
—
WI
Enumeration date
08/10/2005
Last updated
07/08/2007
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