Individual
R. TIM HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
115 W 7TH ST # 229, NEILLSVILLE, WI 54456-1552
(715) 743-3219
Mailing address
PO BOX 229, NEILLSVILLE, WI 54456-0229
(715) 743-3219
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1378
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0807350001
ADMINASTAR FEDERAL
WI
Enumeration date
01/30/2007
Last updated
07/08/2007
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