Individual
DESIREE MONIK HERRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1640 S CHURCH ST, WATERTOWN, WI 53094-6406
(920) 390-2971
(920) 390-2974
Mailing address
1640 S CHURCH ST, WATERTOWN, WI 53094-6406
(920) 390-2971
(920) 390-2974
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3168-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
476900006
MEDICARE ID
WI
Enumeration date
11/23/2009
Last updated
01/05/2016
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