Organization
KENOSHA FAMILY VISION CARE LLC
Active
Other names
Regner Family Vision Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRISTAN ROBERT BEGOTKA O.D. (OWNER)
(262) 694-9103
Entity
Organization
Contact information
Practice address
4014 77TH ST, KENOSHA, WI 53142-4314
(262) 694-9103
(262) 694-9106
Mailing address
4014 77TH ST, KENOSHA, WI 53142-4314
(262) 694-9103
(262) 694-9106
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3309-35
WI
Other
Enumeration date
03/26/2014
Last updated
03/26/2014
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