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General NPI Number Information
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NPI Number | 1538362645
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Entity Type | Organization
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Legal Business Name | STEVEN WINELAND, OD
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 731 PENNSYLVANIA AVE
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City | SHEBOYGAN
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State | WI
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Zip | 53081-4644
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Country | US
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Telephone | 920-452-3127
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Fax |
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Provider Business Mailing Address
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Address Line | 731 PENNSYLVANIA AVE
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City | SHEBOYGAN
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State | WI
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Zip | 53081-4644
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Country | US
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Telephone | 920-452-3127
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEVEN WINELAND
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Credential | OD
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Telephone | 920-452-3127
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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 | 1609
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License Number State | WI
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