Individual
NICHOLAS KONWINSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
955 W CLAIREMONT AVE, EAU CLAIRE, WI 54701-6103
(715) 832-7723
Mailing address
3973 180TH ST, CHIPPEWA FALLS, WI 54729-9165
(715) 828-7476
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3458-35
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/16/2017
Last updated
06/07/2017
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