Organization
FAMILY EYE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
R TIM HARVEY OD (OWNER)
(715) 743-3219
Entity
Organization
Contact information
Practice address
115 W 7TH ST, NEILLSVILLE, WI 54456-1552
(715) 743-3219
Mailing address
PO BOX 229, NEILLSVILLE, WI 54456-0229
(715) 743-3219
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1378
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0807350001
ADMINASTAR FEDERAL
WI
Enumeration date
06/06/2007
Last updated
02/26/2008
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