Individual
CHARLES G NIEBLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2205 N CALHOUN RD, BROOKFIELD, WI 53005-5062
(262) 786-4144
(262) 796-4729
Mailing address
2205 N CALHOUN RD, BROOKFIELD, WI 53005-5062
(262) 786-4144
(262) 796-4729
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1324
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38572500
—
WI
Enumeration date
10/27/2005
Last updated
07/08/2007
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