Organization
OPTICAL DEPT. OF EYE CLINIC OF RACINE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOYCE L SAWASKY (BUSINESS MANAGER)
(262) 637-9615
Entity
Organization
Contact information
Practice address
3805A SPRING ST, SUITE 111, RACINE, WI 53405-1600
(262) 637-9615
(262) 637-4437
Mailing address
PO BOX 1677, RACINE, WI 53401-1677
(262) 637-9615
(262) 637-4437
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38436400
—
WI
Enumeration date
02/01/2006
Last updated
08/22/2020
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