Individual
JAY PAUNOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6012 W NORTH AVE, WAUWATOSA, WI 53213-1528
(414) 453-6500
Mailing address
6012 W NORTH AVE, WAUWATOSA, WI 53213-1528
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38452600
—
WI
Enumeration date
04/10/2008
Last updated
04/10/2008
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