Organization
PARK PLACE OPTICAL, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL P VRABEC M.D. (OFFICER)
(920) 739-8235
Entity
Organization
Contact information
Practice address
21 PARK PL, APPLETON, WI 54914-8872
(920) 739-8235
(920) 749-8095
Mailing address
21 PARK PL, APPLETON, WI 54914-8872
(920) 739-8235
(920) 749-8095
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38424500
—
WI
Enumeration date
03/15/2007
Last updated
01/12/2017
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