Organization
CRANDON VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN ANN WHITT-BARKER (OFFICE MANAGER)
(715) 478-2401
Entity
Organization
Contact information
Practice address
103 E WASHINGTON ST, CRANDON, WI 54520-1392
(715) 478-2401
(715) 478-3663
Mailing address
103 E WASHINGTON ST, CRANDON, WI 54520-1392
(715) 478-2401
(715) 478-3663
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1494-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38553700-38703000
—
WI
Enumeration date
09/20/2006
Last updated
07/10/2008
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