Individual
DR. BRIAN J JURGENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2300 N MAYFAIR RD, #1155, WAUWATOSA, WI 53226-1505
(414) 258-6880
(414) 258-5686
Mailing address
2300 N MAYFAIR RD, #1155, WAUWATOSA, WI 53226-1505
(414) 258-6880
(414) 258-5686
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2499
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38589600
—
WI
Enumeration date
10/10/2005
Last updated
08/08/2008
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