Organization
KNIGHT VISION & GLAUCOMA SPECIALISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN M. BOULANGER (ADMINISTRATOR)
(414) 453-2534
Entity
Organization
Contact information
Practice address
7300 W GREENFIELD AVE, WEST ALLIS, WI 53214-4729
(414) 453-6667
(414) 774-5505
Mailing address
7300 W GREENFIELD AVE, WEST ALLIS, WI 53214-4729
(414) 453-6667
(414) 774-5505
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2138-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38529800
—
WI
Enumeration date
09/16/2006
Last updated
03/03/2009
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