Individual
DR. LAWRENCE JOHANSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1000 W NORTHLAND AVE, APPLETON, WI 54914-1419
(920) 731-4511
(920) 731-9332
Mailing address
1000 W NORTHLAND AVE, APPLETON, WI 54914-1419
(920) 731-4511
(920) 731-9332
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WI 2007
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38525100
—
WI
Enumeration date
05/12/2006
Last updated
07/08/2007
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