Organization
PRN EYE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTOPHER T KNOUS O.D. (OWNER)
(262) 352-7932
Entity
Organization
Contact information
Practice address
950 PORT WASHINGTON RD, GRAFTON, WI 53024-9201
(262) 204-1063
Mailing address
935 N GRANT ST, PORT WASHINGTON, WI 53074-1459
(262) 352-7932
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2999
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147398
PTAN
—
Enumeration date
08/29/2011
Last updated
08/29/2011
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