Individual
DR. SANDRA MARIE LANDWEHR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
PO BOX 12645, GREEN BAY, WI 54307-2645
(920) 494-2121
(920) 221-0117
Mailing address
PO BOX 12645, GREEN BAY, WI 54307-2645
(920) 494-2121
(920) 221-0117
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2188
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770544603
—
WI
05
—
38531700
—
WI
Enumeration date
03/30/2006
Last updated
09/09/2024
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