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Organization

COMMUNITY EYECARE CENTER SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY L. BYERS O.D. (PRESIDENT)
(715) 258-2020
Entity
Organization

Contact information

Practice address
222 S WASHINGTON ST, WAUPACA, WI 54981-1531
(715) 258-2020
(715) 258-9301
Mailing address
222 S WASHINGTON ST, WAUPACA, WI 54981-1531
(715) 258-2020
(715) 258-9301

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2492
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110001714
WEA
WI
05
38727200
WI
Enumeration date
03/22/2007
Last updated
04/23/2012
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