Individual
JANICE LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
11340 N. PT. WASHINGTON RD., MEQUON, WI 53092
(262) 240-0455
Mailing address
11340 N PT WASHINGTON RD, MEQUON, WI 53092-3412
(262) 240-0455
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3269-35
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020677066
EMPLOYER/STORE
WI
Enumeration date
06/19/2012
Last updated
06/19/2012
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