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General NPI Number Information
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NPI Number | 1558547810
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Entity Type | Organization
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Legal Business Name | RIVER VALLEY VISION, S.C.
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 02/11/2014
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Provider Practice Location Address
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Address Line | 2600 STEIN BLVD
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City | EAU CLAIRE
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State | WI
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Zip | 54701
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Country | US
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Telephone | 715-832-4946
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Fax | 715-832-0699
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Provider Business Mailing Address
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Address Line | 2600 STEIN BLVD
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City | EAU CLAIRE
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State | WI
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Zip | 54701
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Country | US
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Telephone | 715-832-4946
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Fax | 715-832-0699
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | REBECCA KABAT
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Credential | O.D.
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Telephone | 715-832-4946
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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 | 1355035
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3035-035
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License Number State | WI
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