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Individual

DR. JAMES JOSEPH BAIETTO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
712 E SUMMIT AVE, OCONOMOWOC, WI 53066
(262) 567-2295
Mailing address
6838 PHEASANT RUN, OCONOMOWOC, WI 53066
(262) 567-2619

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01399
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38571700
WI
Enumeration date
03/16/2006
Last updated
07/08/2007
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