Individual
KAREN VANDENHOUTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
923 ELIZA ST, GREEN BAY, WI 54301-3234
(920) 965-4700
(920) 965-4701
Mailing address
923 ELIZA ST, GREEN BAY, WI 54301-3234
(920) 965-4700
(920) 965-4701
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38453300
—
WI
Enumeration date
04/03/2008
Last updated
04/03/2008
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