Individual
DARYL L KRUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
5802 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-4050
(414) 955-2020
(414) 955-6300
Mailing address
5802 WASHINGTON AVE, MOUNT PLEASANT, WI 53406-4050
(414) 955-2020
(414) 955-6300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2442035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659361772
—
WI
05
—
38583600
—
WI
Enumeration date
10/28/2005
Last updated
09/25/2019
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