Vita Park Eye Associates, Sc

NPI #1548286909 in Waupun, Wisconsin

Provider Information

NPI Number: 1548286909
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: Optometrist
Enumeration Date: Jul 15, 2006
Last Updated: Apr 21, 2021

Practice Location

Address: 140 GATEWAY DR
City: Waupun
State: Wisconsin
ZIP Code: 53963-2276
Phone: (920) 324-3191

Authorized Official

Name: THOMAS CASTILLO, DO
Title: CORPORATION OFFICER
Phone: (920) 887-1151

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X
Optometrist	152W00000X	Primary

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