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General NPI Number Information
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NPI Number | 1437253077
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Entity Type | Organization
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Legal Business Name | RIVER FALLS EYE SURGERY AND LASER CENTER INC.
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 10/01/2008
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Provider Practice Location Address
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Address Line | 183 E POMEROY ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-3506
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Country | US
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Telephone | 715-425-0015
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Fax | 715-425-6001
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Provider Business Mailing Address
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Address Line | 183 E POMEROY ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-3506
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Country | US
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Telephone | 715-425-0115
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Fax | 715-425-6001
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANTHONY F NOVAK
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Credential | M.D.
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Telephone | 715-425-0115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 30071-20
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License Number State | WI
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