Organization
EYES ON THE LAKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VAUGN SCHNEIDER OD (OPTOMETRIST / OWNER)
(920) 850-1367
Entity
Organization
Contact information
Practice address
2134 S KINNICKINNIC AVENUE, MILWAUKEE, WI 53207-1379
(414) 293-1180
(414) 293-1181
Mailing address
2134 S KINNICKINNIC AVENUE, MILWAUKEE, WI 53207-1379
(414) 293-1180
(414) 293-1181
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124478144
—
WI
Enumeration date
10/20/2021
Last updated
05/19/2022
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