Individual
MS. JANE A BACHMAN GROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
925 N 87TH ST, MED COLLEGE CLINICS AT THE EYE INST, MILWAUKEE, WI 53226-4812
(414) 456-2020
(414) 456-6300
Mailing address
925 N 87TH ST, MED COLLEGE CLINICS AT THE EYE INST, MILWAUKEE, WI 53226-4812
(414) 456-2020
(414) 456-6300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2406
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005000261U
HUMANA
—
05
—
1932153061
—
WI
05
—
38617600
—
WI
Enumeration date
05/22/2006
Last updated
10/30/2012
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