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General NPI Number Information
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NPI Number | 1720270226
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Entity Type | Organization
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Legal Business Name | EMMERICH VISION CARE, LLC
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 6321 MCKEE RD.
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City | FITCHBURG
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State | WI
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Zip | 53719
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Country | US
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Telephone | 608-274-6747
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Fax | 608-274-6793
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Provider Business Mailing Address
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Address Line | 5904 SCHUMANN DR
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City | FITCHBURG
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State | WI
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Zip | 53711-5103
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Country | US
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Telephone | 608-274-5246
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Fax | 608-274-6793
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID ALLAN EMMERICH
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Credential | O.D.
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Telephone | 608-274-6747
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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 | 1798
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License Number State | WI
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