Organization
ROBERT B. BOWER, O.D., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT BRUCE BOWER OD (PRESIDENT)
26265476005
Entity
Organization
Contact information
Practice address
2301 75TH ST, KENOSHA, WI 53143-1403
(262) 654-6005
Mailing address
2301 75TH ST, KENOSHA, WI 53143-1403
(262) 654-6005
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1496
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38525800
—
WI
Enumeration date
03/23/2007
Last updated
06/24/2008
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