MEDICARE: TOWER CLOCK EYE CENTER SC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	152W00000X	Optometrist
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1376272047
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWER CLOCK EYE CENTER SC

Provider Business Mailing Address
First Line	:	1087 W MASON ST
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54303-1859
Country	:	US
Telephone Number	:	920-499-3102
Fax Number	:

Provider Business Practice Location Address
First Line	:	3142 N RICHMOND ST
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54911-1151
Country	:	US
Telephone Number	:	920-499-3102
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	DANIELLE JORGENSEN
Credential	:
Telephone Number	:	920-593-5724

Provider Enumeration Date	:	06/08/2022
Last Update Date	:	06/24/2025

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Directions to “TOWER CLOCK EYE CENTER SC ” Practice Location

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