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General NPI Number Information
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NPI Number | 1801998729
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Entity Type | Organization
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Legal Business Name | TOWER CLOCK EYE CENTER SC
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1087 W MASON STREET
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City | GREEN BAY
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State | WI
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Zip | 54303-1859
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Country | US
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Telephone | 920-499-3102
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Fax | 920-499-9636
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Provider Business Mailing Address
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Address Line | 1087 W MASON STREET
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City | GREEN BAY
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State | WI
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Zip | 54303-1859
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Country | US
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Telephone | 920-499-3102
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Fax | 920-499-9636
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | DANIELLE MARIE JORGENSEN
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Credential |
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Telephone | 920-593-5724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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