Individual
DIANE L WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
100 N MAIN ST, RICHLAND CENTER, WI 53581-2237
(608) 647-8995
(608) 647-2569
Mailing address
705 S UNIVERSITY AVE, STE 510, BEAVER DAM, WI 53916-3081
(920) 885-8551
(920) 885-8565
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2570-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1006556
PHYSICIANS PLUS
WI
05
—
38591400
—
WI
01
—
8070
DEAN HEALTH INSURANCE
WI
Enumeration date
05/19/2006
Last updated
07/08/2007
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