Organization
DANIEL L. GAUERKEI DBA BROADWAY VISION CENTER
Active
Other names
Broadway Vision Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEIDY J GUYER (PRACTICE MANAGER)
(715) 258-9122
Entity
Organization
Contact information
Practice address
815 W FULTON ST, SUITE 103, WAUPACA, WI 54981-1405
(715) 258-9122
(715) 258-3090
Mailing address
815 W FULTON ST, SUITE 103, WAUPACA, WI 54981-1405
(715) 258-9122
(715) 258-3090
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
1938
WI
Other
Enumeration date
10/29/2007
Last updated
10/29/2010
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