Individual
JOHN ARTHUR MCINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
100 ARCADIAN AVENUE, WAUKESHA, WI 53186
(262) 542-3676
(262) 542-3826
Mailing address
W8116 CANTERBURY LANE, #11, LAKE MILLS, WI 53551
(920) 648-3090
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2192
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38532200
—
WI
Enumeration date
08/12/2006
Last updated
07/08/2007
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