Individual
DR. TODD M YACKELS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2950 S CHASE AVE, MILWAUKEE, WI 53207-6407
(414) 483-1092
(414) 483-1095
Mailing address
1221 COBBLESTONE PL, WEST BEND, WI 53095-4585
(262) 335-2902
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2479-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38582700
—
WI
Enumeration date
03/30/2006
Last updated
07/08/2007
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