Individual
MICHAEL ERIC BANWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2001 N CENTRAL AVE, MARSHFIELD, WI 54449-8337
(715) 486-9365
(715) 486-1426
Mailing address
2401 MONIQUE LN APT 2, MARSHFIELD, WI 54449-2439
(406) 868-7836
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3005-035
WI
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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