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NPI Code Detail

MEDICARE: SWANSON EYE CARE INC

MEDICARE: SWANSON EYE CARE INC
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
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1144609322
Entity Type Code : Organization
Provider Name (Legal Business Name) : SWANSON EYE CARE INC
Provider Business Mailing Address
First Line : 2900 S WISCONSIN AVE
Second Line :
City : RICE LAKE
State : WI
Zip : 54868-8578
Country : US
Telephone Number : 608-341-9636
Fax Number :
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 : 608-341-9636
Fax Number :
Authorized Official
Title or Position : OWNER DOCTOR
Name : DR. TODD SWANSON
Credential : OD
Telephone Number : 608-341-9636
Provider Enumeration Date : 05/21/2015
Last Update Date : 05/21/2015

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Directions to “SWANSON EYE CARE INC ” Practice Location

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