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Individual

DR. KATHRYN ANN KORTH

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
O.D., F.A.A.O.

Contact information

Practice address
1000 W NORTHLAND AVE, SHOPKO OPTICAL, APPLETON, WI 54914-1419
(920) 731-4511
Mailing address
1018 E BYRD ST, APPLETON, WI 54911-3041
(920) 830-3351

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2441
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38586100
WI
Enumeration date
05/17/2006
Last updated
07/08/2007
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