Individual
PAUL MARTIN GODICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3670 S 108TH ST, STE 204, GREENFIELD, WI 53228-1237
(414) 453-1010
(414) 425-4230
Mailing address
3670 S 108TH ST, STE 204, GREENFIELD, WI 53228-1237
(414) 453-1010
(414) 425-4230
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1297
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38501000
—
WI
Enumeration date
12/16/2005
Last updated
01/25/2017
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