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Individual

WILLIAM VINCENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
N95W18437 COUNTY LINE RD, MENOMONEE FALLS, WI 53051-7101
(262) 532-0570
(262) 532-0575
Mailing address
11103 WEST AVE, SUITE 6, SAN ANTONIO, TX 78213-1370
(210) 524-6663
(210) 524-6587

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2120-035
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38529600
WI
Enumeration date
12/28/2006
Last updated
07/09/2007
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