Organization
EYE PROSTHETICS OF WISCONSIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN TYNES B.C.O. (OCULARIST)
(262) 754-3681
Entity
Organization
Contact information
Practice address
13255 W BLUEMOUND RD, 101, BROOKFIELD, WI 53005-6245
(262) 754-3681
(262) 754-3682
Mailing address
13255 W BLUEMOUND RD, 101, BROOKFIELD, WI 53005-6245
(262) 754-3681
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41731500
—
WI
Enumeration date
04/11/2006
Last updated
02/19/2024
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