MEDICARE: DR. VALERIE L FRAZER OD

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
1	152WV0400X	Vision Therapy Optometrist	2913-035	WI
2	152W00000X	Optometrist	2913-035	WI

General Provider Information

NPI Number	:	1417929456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALERIE L FRAZER OD

Provider Business Mailing Address
First Line	:	1021 QUINN DR STE 400
Second Line	:
City	:	WAUNAKEE
State	:	WI
Zip	:	53597-2502
Country	:	US
Telephone Number	:	608-849-4040
Fax Number	:	608-849-4042

Provider Business Practice Location Address
First Line	:	1021 QUINN DR STE 400
Second Line	:
City	:	WAUNAKEE
State	:	WI
Zip	:	53597-2502
Country	:	US
Telephone Number	:	608-849-4040
Fax Number	:	608-849-4042

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	04/10/2024

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