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Organization

EYE & VISION CLINICS, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER POTTS (CLINIC MANAGER)
(920) 336-7700
Entity
Organization

Contact information

Practice address
301 N BROADWAY, DE PERE, WI 54115-2557
(920) 336-7700
(920) 338-1799
Mailing address
301 N BROADWAY, DE PERE, WI 54115-2557
(920) 336-7700
(920) 338-1799

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1428
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003927278
NPI FOR DAVID DUFECK
WI
01
1194812099
NPI FOR MATTHEW L NELSON
WI
Enumeration date
03/26/2007
Last updated
03/20/2015
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