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Individual

MR. DEAN ALLEN DELWICHE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
21 PARK PL, APPLETON, WI 54914-8872
(920) 739-4361
(920) 739-6368
Mailing address
21 PARK PL, APPLETON, WI 54914-8872
(920) 739-4361
(920) 739-6368

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2422
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38585500
WI
Enumeration date
06/18/2006
Last updated
03/26/2013
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