Organization
SE PROFESSIONALS, S.C.
Active
Other names
Premier Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KING AYMOND MD (OWNER)
(920) 467-7000
Entity
Organization
Contact information
Practice address
120 MARTIN DR, FREDONIA, WI 53021-9455
(262) 692-9000
(262) 692-2797
Mailing address
120 MARTIN DR, FREDONIA, WI 53021-9455
(262) 692-9000
(262) 692-2797
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38722100
—
WI
Enumeration date
10/26/2006
Last updated
10/31/2012
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