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General NPI Number Information
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NPI Number | 1710125661
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Entity Type | Organization
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Legal Business Name | DAVID SAVAGLIO EYECARE, LLC
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Dates
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Enumeration Date | 01/30/2009
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 7630 PERSHING BLVD
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City | KENOSHA
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State | WI
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Zip | 53142-4318
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Country | US
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Telephone | 262-694-4989
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Fax |
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Provider Business Mailing Address
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Address Line | 4527 23RD AVE
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City | KENOSHA
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State | WI
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Zip | 53140-5928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. DAVID SAVAGLIO
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Credential | O.D.
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Telephone | 262-745-9633
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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 | 2831-035
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License Number State | WI
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