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DR. MICHAEL DESMOND MAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1220 PARKWOOD DR, WISCONSIN RAPIDS, WI 54494-5488
(715) 421-2111
(715) 421-2123
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(517) 223-6780

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3021-035
WI

Other

Enumeration date
06/14/2006
Last updated
05/24/2021
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