Antigo Vision Clinic Sc

NPI #1295915460 in Antigo, Wisconsin

Provider Information

NPI Number: 1295915460
Entity Type: Organization
Organization Name: Antigo Vision Clinic Sc
Primary Specialty: Optometrist
Enumeration Date: Nov 5, 2007
Last Updated: Aug 26, 2008

Practice Location

Address: 714 3RD AVE
City: Antigo
State: Wisconsin
ZIP Code: 54409-2044
Phone: (715) 623-2180

Authorized Official

Name: DR. RICHARD ARTHUR KJOME, OD
Title: PRESIDENT
Phone: (715) 623-2180

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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