Individual
PATRICK JODE SAMELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2330 ONEIDA ST, SUITE 106, GREEN BAY, WI 54304
(920) 496-9699
(920) 496-1540
Mailing address
2330 ONEIDA ST, SUITE 106, GREEN BAY, WI 54304
(920) 496-9699
(920) 496-1540
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2517
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2517
STATE LICENSE
WI
Enumeration date
12/04/2006
Last updated
08/18/2008
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