Individual
WAYNE R KOEHLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449
(715) 387-5725
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2440
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38585200
—
WI
Enumeration date
08/21/2006
Last updated
07/08/2007
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