Individual
TERESA RUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
223 E MAIN ST, WAUPUN, WI 53963-2019
(920) 324-8608
(920) 324-8699
Mailing address
223 E MAIN ST, P.O. BOX 163, WAUPUN, WI 53963-2019
(920) 324-8608
(920) 324-8699
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
157064
WI
Other
Enumeration date
12/24/2012
Last updated
12/24/2012
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