Organization
WATERTOWN VISION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON PROCTO (OWNER/OPERATOR)
(414) 810-8003
Entity
Organization
Contact information
Practice address
1640 S CHURCH ST, WATERTOWN, WI 53094-6406
(920) 390-2971
(920) 390-2974
Mailing address
1640 S CHURCH ST, WATERTOWN, WI 53094-6406
(920) 390-2971
(920) 390-2974
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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