Organization
JANET S WHITE
Active
Other names
Jans Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET SUSAN WHITE (OWNER)
(920) 324-8608
Entity
Organization
Contact information
Practice address
223 E MAIN ST, WAUPUN, WI 53963-0163
(920) 324-8608
(920) 324-8699
Mailing address
PO BOX 163, WAUPUN, WI 53963-0163
(920) 324-8608
(920) 324-8699
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
156FX1202X
Optometric Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38709800
—
WI
01
—
410047488
RR MEDICARE
WI
Enumeration date
09/14/2006
Last updated
07/16/2008
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