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General NPI Number Information
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NPI Number | 1932282928
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Entity Type | Organization
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Legal Business Name | KIND OPTICAL INC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 09/17/2009
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Provider Practice Location Address
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Address Line | 3925 S 76TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53220-2320
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Country | US
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Telephone | 414-543-2900
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Fax | 414-543-9130
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Provider Business Mailing Address
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Address Line | 3925 S 76TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53220-2320
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Country | US
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Telephone | 414-543-2900
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Fax | 414-543-9130
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KAREN FOSTER MERKLE
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Credential | O.D.
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Telephone | 414-543-2900
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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 | 1595-035
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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