Individual
JAIME D BLANCHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
7300 W GREENFIELD AVE, WEST ALLIS, WI 53214-4729
(414) 453-6667
(414) 774-5505
Mailing address
7300 W GREENFIELD AVE, WEST ALLIS, WI 53214-4729
(414) 453-6667
(414) 774-5505
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2968-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38622400
—
WI
Enumeration date
06/09/2005
Last updated
09/03/2014
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