Organization
WAL-MART SUPERCENTER 1277
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER JOHN LAWSON (VISION CENTER MANAGER)
(715) 284-1592
Entity
Organization
Contact information
Practice address
611 STATE HIGHWAY 54, BLACK RIVER FALLS, WI 54615-5453
(715) 284-1592
(715) 284-1604
Mailing address
611 STATE HIGHWAY 54, BLACK RIVER FALLS, WI 54615-5453
(715) 284-1592
(715) 284-1604
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/18/2007
Last updated
10/18/2007
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