Organization
INNOVATIVE OPTIQUE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GUADALUPE AGUILAR (OWNER)
(414) 228-9873
Entity
Organization
Contact information
Practice address
333 W BROWN DEER RD, MILWAUKEE, WI 53217-2372
(414) 228-9873
(414) 228-9841
Mailing address
333 W BROWN DEER RD, MILWAUKEE, WI 53217-2372
(414) 228-9873
(414) 228-9841
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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