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NPI Code Detail

MEDICARE: SAUKVILLE FAMILY EYE CENTER LLC

MEDICARE: SAUKVILLE FAMILY EYE CENTER LLC
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
1152W00000XOptometrist2992WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1851670921
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAUKVILLE FAMILY EYE CENTER LLC
Provider Business Mailing Address
First Line : 935 N GRANT ST
Second Line :
City : PORT WASHINGTON
State : WI
Zip : 53074-1459
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 825 E GREEN BAY AVE
Second Line :
City : SAUKVILLE
State : WI
Zip : 53080-2618
Country : US
Telephone Number : 262-352-7907
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. MELISSA J KNOUS
Credential : O.D.
Telephone Number : 262-352-7907
Provider Enumeration Date : 08/08/2011
Last Update Date : 08/08/2011

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Directions to “SAUKVILLE FAMILY EYE CENTER LLC ” Practice Location

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