Individual
SOREN A. NYWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1220 PARKWOOD DRIVE, WISCONSIN RAPIDS, WI 54494-5488
(715) 421-2111
(715) 421-2123
Mailing address
1220 PARKWOOD DRIVE, WISCONSIN RAPIDS, WI 54494-5488
(715) 421-2111
(715) 421-2123
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1687-035
WI
Other
Enumeration date
08/23/2005
Last updated
05/13/2009
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