Individual
DR. ALYCE ANASTASIA HOFMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
740 REENA AVE, SUITE B, FORT ATKINSON, WI 53538-3145
(920) 563-8468
Mailing address
740 REENA AVE, SUITE B, FORT ATKINSON, WI 53538-3145
(920) 563-8468
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046-009524
IL
152W00000X
Optometrist
Primary
3138-35
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427191881
—
WI
01
—
P01734884
RAILROAD MEDICARE
WI
Enumeration date
02/15/2007
Last updated
12/07/2016
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