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Organization

KEVIN A. HARRY, O.D.

Active
Other names
Signature Eyecare
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN ALLEN HARRY OD (OWNER-OPTOMETRIST)
(262) 786-9630
Entity
Organization

Contact information

Practice address
17125 W BLUEMOUND RD, SUITE F, BROOKFIELD, WI 53005-5948
(262) 786-9630
(262) 786-3972
Mailing address
17125 W BLUEMOUND RD, SUITE F, BROOKFIELD, WI 53005-5948
(262) 786-9630
(262) 786-3972

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
WI 2179
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38575400
WI
Enumeration date
05/19/2007
Last updated
06/12/2008
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