Organization
EYE & VISION CLINICS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER POTTS (CLINIC MANAGER)
(920) 845-5555
Entity
Organization
Contact information
Practice address
140 SCHOOL CREEK TRL, LUXEMBURG, WI 54217-1095
(920) 845-5555
(920) 845-5219
Mailing address
140 SCHOOL CREEK TRL, LUXEMBURG, WI 54217-1095
(920) 845-5555
(920) 845-5219
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1428
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003927278
NPI FOR DAVID R DUFECK
WI
01
—
1194812099
NPI FOR MATTHEW L NELSON
WI
01
—
1790731743
NPI FOR TIMOTHY J CORGAN
WI
01
—
1881711588
NPI FOR DEPERE CLINIC
WI
Enumeration date
03/26/2007
Last updated
03/20/2015
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