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NPI Code Detail

MEDICARE: CHARLES KENT MENG O D LTD

MEDICARE: CHARLES KENT MENG O D LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332H00000XEyewear Supplier01449WI

General Provider Information

NPI Number : 1144486614
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLES KENT MENG O D LTD
Provider Business Mailing Address
First Line : 2900 S WISCONSIN AVE
Second Line :
City : RICE LAKE
State : WI
Zip : 54868-8578
Country : US
Telephone Number : 715-234-2787
Fax Number : 715-234-8920
Provider Business Practice Location Address
First Line : 2900 S WISCONSIN AVE
Second Line :
City : RICE LAKE
State : WI
Zip : 54868-8578
Country : US
Telephone Number : 715-234-2787
Fax Number : 715-234-8920
Authorized Official
Title or Position : DOCTOR/OWNER
Name : DR. CHARLES KENT MENG
Credential : O.D.
Telephone Number : 715-234-1787
Provider Enumeration Date : 08/04/2008
Last Update Date : 10/01/2008

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