Organization
SHEBOYGAN OPTICAL CO. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER LARSON M. D. (OWNER)
(920) 458-5096
Entity
Organization
Contact information
Practice address
1442 N 31ST ST, SHEBOYGAN, WI 53081-3061
(920) 458-5096
(920) 451-1085
Mailing address
1442 N 31ST ST, SHEBOYGAN, WI 53081-3061
(920) 458-5096
(920) 451-1085
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
03/19/2007
Last updated
07/08/2014
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