Healthcare Provider Details

I. General information

NPI: 1386578995
Provider Name (Legal Business Name): ALEC ROHRER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 PARK PL
APPLETON WI
54914-8872
US

IV. Provider business mailing address

21 PARK PL
APPLETON WI
54914-8872
US

V. Phone/Fax

Practice location:
  • Phone: 920-739-4361
  • Fax:
Mailing address:
  • Phone: 920-739-4361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4140-35
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: