Organization
OPHTHALMOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN E GRAVES MD (PARTNER)
(414) 543-6887
Entity
Organization
Contact information
Practice address
6020 S PACKARD AVE, CUDAHY, WI 53110-3028
(414) 543-6887
Mailing address
6020 S PACKARD AVE, CUDAHY, WI 53110-3028
(414) 294-4660
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0565030001
DMERC (MC DURABLE MEDICAL
WI
Enumeration date
05/08/2007
Last updated
03/08/2024
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