Individual
DR. JAMIE LYNN ERTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
723 MAIN AVE, DE PERE, WI 54115-1371
(920) 336-3390
Mailing address
723 MAIN AVE, DE PERE, WI 54115-1371
(920) 336-3390
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3033035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38645400
—
WI
Enumeration date
10/28/2005
Last updated
05/15/2021
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