Organization
SHOPTIKAL LLC
Active
Other names
Shopko Optical 4177
Organization subpart
No
Provider details
NPI number
Authorized official
RUSS STEINHORST (EVP & CFO)
(920) 429-7842
Entity
Organization
Contact information
Practice address
2314 LINEVILLE RD STE 104, GREEN BAY, WI 54313-8860
(920) 434-5845
Mailing address
P.O. BOX 19060, GREEN BAY, WI 54307
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
05/13/2019
Last updated
11/29/2024
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