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General NPI Number Information
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NPI Number | 1265698187
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Entity Type | Individual
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Provider Name | SARA C FALTER O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 555 S 108TH ST
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City | WEST ALLIS
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State | WI
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Zip | 53214-1145
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Country | US
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Telephone | 414-566-3050
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Fax |
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Provider Business Mailing Address
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Address Line | W217N9704 WHITEHORSE DR
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City | COLGATE
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State | WI
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Zip | 53017-9562
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Country | US
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Telephone | 713-865-0128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3113-35
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License Number State | WI
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