Eye Clinic of Manitowoc, S.c.

NPI #1437144417 in Manitowoc, Wisconsin

Provider Information

NPI Number: 1437144417
Entity Type: Organization
Organization Name: Eye Clinic of Manitowoc, S.c.
Primary Specialty: Ophthalmology
Enumeration Date: Sep 15, 2005
Last Updated: Nov 19, 2009

Practice Location

Address: 4801 EXPO DR
City: Manitowoc
State: Wisconsin
ZIP Code: 54220-9341
Phone: (920) 684-4429

Authorized Official

Name: DR. DONALD R LEWELLEN, M.D.
Title: OPHTHALMOLOGIST/VICE PRESIDENT
Phone: (920) 684-4429

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X
Technician/Technologist - Optician — Optician	156FX1800X
Ophthalmology	207W00000X	Primary

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