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General NPI Number Information
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NPI Number | 1740333806
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Entity Type | Organization
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Legal Business Name | VISION & EYE HEALTH ASSOCIATES, LLC
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 1035 PLEASANT ST STE C
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City | BELOIT
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State | WI
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Zip | 53511-4453
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Country | US
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Telephone | 608-365-9591
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Fax | 608-365-0815
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Provider Business Mailing Address
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Address Line | 1035 PLEASANT ST SUITE C
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City | BELOIT
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State | WI
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Zip | 53511-4468
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Country | US
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Telephone | 608-365-9591
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Fax | 608-365-0815
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Authorized Official
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Title or Position | BUSINESS OWNER,OPERATOR
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Name | DR. JEFFERY F KNEIERT
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Credential | O.D.
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Telephone | 608-365-9591
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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 | 2503
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License Number State | WI
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