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Individual

RONALD DEMARK

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3415 CALUMET AVE, MANITOWOC, WI 54220-5427
(920) 683-2244
(920) 684-7706
Mailing address
3415 CALUMET AVE, MANITOWOC, WI 54220-5427
(920) 683-2244
(920) 684-7706

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1403
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38513200
WI
Enumeration date
05/20/2006
Last updated
07/08/2007
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