MEDICARE: MULLER EYECARE ASSOCIATES 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
1	152W00000X	Optometrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410038845	OTHER	WI	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1447441779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULLER EYECARE ASSOCIATES LTD

Provider Business Mailing Address
First Line	:	1776 E MASON ST
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54302-3251
Country	:	US
Telephone Number	:	920-468-8907
Fax Number	:	920-468-0225

Provider Business Practice Location Address
First Line	:	1776 E MASON ST
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54302
Country	:	US
Telephone Number	:	920-468-8907
Fax Number	:	920-468-0225

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. TERESA A RUNTE
Credential	:
Telephone Number	:	920-468-8907

Provider Enumeration Date	:	08/01/2007
Last Update Date	:	02/18/2015

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