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General NPI Number Information
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NPI Number | 1588746671
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Entity Type | Organization
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Legal Business Name | DRS. ELLIOTT & WEBB, S.C.
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 11/10/2008
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Provider Practice Location Address
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Address Line | 1205 SUFFOLK DR
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City | JANESVILLE
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State | WI
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Zip | 53546-1606
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Country | US
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Telephone | 608-754-3379
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Fax | 608-741-1506
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Provider Business Mailing Address
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Address Line | 1205 SUFFOLK DR
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City | JANESVILLE
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State | WI
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Zip | 53546-1606
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Country | US
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Telephone | 608-754-3379
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Fax | 608-741-1506
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Authorized Official
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Title or Position | OWNER
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Name | DR. HERBERT T WEBB III
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Credential | O.D.
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Telephone | 608-754-3379
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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 | 2646-035
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License Number State | WI
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