Individual
DR. JUSTIN DEAN ATHERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
601 W ADAMS ST, BLACK RIVER FALLS, WI 54615-9010
(715) 274-6451
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2674
AR
152W00000X
Optometrist
Primary
3461
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2674
LISCENCE #
AR
Enumeration date
07/25/2012
Last updated
07/21/2022
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