Individual
DR. ROBERT L FAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
309 MCHENRY ST, BURLINGTON, WI 53105-2123
(262) 763-0117
(262) 763-0119
Mailing address
PO BOX 630, 309 MCHENRY ST, BURLINGTON, WI 53105-0630
(262) 763-0117
(262) 763-0119
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1332035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38569200
—
WI
Enumeration date
06/19/2006
Last updated
11/15/2016
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