Organization
JACKSON VISION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZHALEH BARARI O.D. (OWNER)
(262) 677-4313
Entity
Organization
Contact information
Practice address
W194N16747 EAGLE DR, SUITE N, JACKSON, WI 53037-9797
(262) 677-4313
(262) 677-4396
Mailing address
W194N16747 EAGLE DR, SUITE N, JACKSON, WI 53037-9797
(262) 677-4313
(262) 677-4396
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38615500
—
WI
Enumeration date
03/22/2007
Last updated
11/03/2012
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