Organization
BELOIT FAMILY EYE CARE S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS EDWARD KELLEY OD (MANAGER)
(608) 365-8575
Entity
Organization
Contact information
Practice address
540 E GRAND AVE, BELOIT, WI 53511-6314
(608) 365-8575
(608) 362-2655
Mailing address
540 E GRAND AVE, BELOIT, WI 53511-6314
(608) 365-8575
(608) 362-2655
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3136-035
WI
Other
Enumeration date
05/11/2011
Last updated
08/17/2011
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