Organization
CHIPPEWA VALLEY EYE CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY M SIPPLE (ADMINISTRATOR)
(715) 552-9337
Entity
Organization
Contact information
Practice address
2715 DAMON ST, EAU CLAIRE, WI 54701-2634
(715) 834-8471
(715) 834-0373
Mailing address
2715 DAMON ST, EAU CLAIRE, WI 54701-3899
(715) 834-8471
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
WI
207W00000X
Ophthalmology Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32671200
—
WI
05
—
38721500
—
WI
Enumeration date
08/16/2005
Last updated
06/18/2024
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