Organization
KOSKINEN EYE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLENA J PETERSON (OFFICE MANAGER)
(262) 642-9719
Entity
Organization
Contact information
Practice address
3278 W MAIN ST, SUITE B, EAST TROY, WI 53120
(262) 642-9719
(262) 642-2228
Mailing address
PO BOX 165, EAST TROY, WI 53120-0165
(262) 642-9719
(262) 642-2228
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2184
WI
Other
Enumeration date
04/16/2007
Last updated
02/09/2009
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