Individual
JACOB B VERGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
331 E PRAIRIE VIEW RD, CHIPPEWA FALLS, WI 54729-3463
(715) 726-9077
Mailing address
13151 39TH AVE N, CHIPPEWA FALLS, WI 54729-7144
(773) 297-5096
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3083-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38642900
—
WI
Enumeration date
07/03/2007
Last updated
06/23/2008
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