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General NPI Number Information
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NPI Number | 1285804807
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Entity Type | Organization
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Legal Business Name | PARKWOOD EYECARE ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 1220 PARKWOOD DR
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-5488
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Country | US
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Telephone | 715-421-2111
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Fax | 715-421-2123
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Provider Business Mailing Address
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Address Line | 1220 PARKWOOD DR
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City | WISCONSIN RAPIDS
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State | WI
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Zip | 54494-5488
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Country | US
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Telephone | 715-421-2111
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Fax | 715-421-2123
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | STEPHEN CARL STERNITZKY
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Credential | O.D.
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Telephone | 715-421-2111
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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 | 1687035
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License Number State | WI
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