Vita Park Eye Associates, Sc
NPI #1447276894 in Beaver Dam, Wisconsin
Provider Information
- NPI Number
- 1447276894
- Entity Type
- Organization
- Organization Name
- Vita Park Eye Associates, Sc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- VITA PARK EYE ASSOCIATES, SC
- Primary Specialty
- Ophthalmology
- Enumeration Date
- Jul 15, 2006
- Last Updated
- Apr 21, 2021
Practice Location
- Address
- 240 CORPORATE DRIVE
- City
- Beaver Dam
- State
- Wisconsin
- ZIP Code
- 53916-3115
- Phone
- (920) 887-1151
Authorized Official
- Name
- THOMAS CASTILLO, DO
- Title
- CORPORATION OFFICER
- Phone
- (920) 887-1151
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
| Ophthalmology |
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