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NPI Code Detail

MEDICARE: HERSLOF'S, INC

MEDICARE: HERSLOF'S, 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
1156FX1800XOptician

General Provider Information

NPI Number : 1952430456
Entity Type Code : Organization
Provider Name (Legal Business Name) : HERSLOF'S, INC
Provider Business Mailing Address
First Line : 12000 W CARMEN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53225-2116
Country : US
Telephone Number : 414-462-1300
Fax Number :
Provider Business Practice Location Address
First Line : 130 E CAPITOL DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53212-1206
Country : US
Telephone Number : 414-962-6744
Fax Number :
Authorized Official
Title or Position : VP
Name : VICKI DICKMAN
Credential :
Telephone Number : 414-462-1300
Provider Enumeration Date : 03/02/2007
Last Update Date : 08/22/2020

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Directions to “HERSLOF'S, INC ” Practice Location

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