Wautoma Eye Clinic S.c.

NPI #1972628584 in Wautoma, Wisconsin

Provider Information

NPI Number: 1972628584
Entity Type: Organization
Organization Name: Wautoma Eye Clinic S.c.
Primary Specialty: Optometrist
Enumeration Date: Mar 20, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: N2577 PLAZA RD
City: Wautoma
State: Wisconsin
ZIP Code: 54982-7706
Phone: (920) 787-3837

Authorized Official

Name: DR. BRIAN L. MECKELBERG, OD
Title: OWNER
Phone: (920) 787-3837

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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